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SHOPKO PHARMACY 097
NPI 1194776179
Pharmacy - Community/Retail Pharmacy in West Valley City, UT

Active since May 13, 2006
4850 W 3500 S, WEST VALLEY CITY, UT 84120(801) 966-6500(801) 966-8805 Get Directions Write a Review

NPPES record last updated: August 27, 2013. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Shopko Pharmacy 097 NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHOPKO PHARMACY 097 (NPI 1194776179) is a healthcare organization registered as a community/retail pharmacy in West Valley City, Utah and active in the NPI registry since May 2006. The organization lists Michael J Bettiga, Sr. Vice President Health Services, as its authorized official.

NPPES Registry Identity

NPI1194776179
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameSHOPKO STORES OPERATING CO LLC
Location Address4850 W 3500 SWest Valley City, UT 84120-2927
Mailing Address4850 W 3500 SWest Valley City, UT 84120-2927 · (801) 966-6500 · Fax (801) 966-8805
Phone(801) 966-6500
Fax(801) 966-8805
Organization SubpartNo
Authorized OfficialMichael J BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateMay 13, 2006
Last NPPES UpdateAugust 27, 2013
✔ NPI 1194776179 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in UT · 1320601703
Definition
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
Also ListedEyewear SupplierTaxonomy 332H00000X
4850 W 3500 S, West Valley City, UT 84120
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Other Names 1

Doing Business AsShopko Pharmacy 097

Other Identifiers 5

Other4606945Ncpdp Number
Medicaid410985054151UT
Medicaid=========009UT
Medicare ID-Type Unspecified0154160125
Medicare NSC5695760040

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

STEVEN J MUTCHLER RPH
Pharmacist
4850 W 3500 S
WEST VALLEY CITY, UT 84120
Salt Lake County (801) 966-6500
SHOPKO STORES OPERATING CO. LLC
Eyewear Supplier
4850 W 3500 S
WEST VALLEY CITY, UT 84120
Salt Lake County (801) 967-6300

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shopko Stores Operating Co LLC's NPI number?

The NPI number for Shopko Stores Operating Co LLC is 1194776179. It was assigned to this organization in the NPPES registry on May 13, 2006. The provider is doing business as Shopko Pharmacy 097.

Where is Shopko Stores Operating Co LLC located?

Shopko Stores Operating Co LLC is located at 4850 W 3500 S, West Valley City, UT 84120. The listed phone number is (801) 966-6500.

What is Shopko Stores Operating Co LLC's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

When was this NPI record last updated?

The NPPES record for Shopko Stores Operating Co LLC was last updated on August 27, 2013. NPI Profile syncs with the weekly NPPES data releases published by CMS.