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SHOPKO PHARMACY 075
NPI 1215981014
Pharmacy - Community/Retail Pharmacy in Missoula, MT

Active since May 19, 2006
2510 S RESERVE ST, MISSOULA, MT 59801(406) 721-3789(406) 721-3859 Get Directions Write a Review

NPPES record last updated: August 11, 2009. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Shopko Pharmacy 075 NPPES

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

SHOPKO PHARMACY 075 (NPI 1215981014) is a healthcare organization registered as a community/retail pharmacy in Missoula, Montana 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

NPI1215981014
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameSHOPKO STORES OPERATING CO LLC
Location Address2510 S RESERVE STMissoula, MT 59801-7546
Mailing Address2510 S Reserve StMissoula, MT 59801-7546 · (406) 721-3789 · Fax (406) 721-3859
Phone(406) 721-3789
Fax(406) 721-3859
Organization SubpartNo
Authorized OfficialMichael J BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateMay 19, 2006
Last NPPES UpdateAugust 11, 2009
✔ NPI 1215981014 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in MT · 1199
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
2510 S RESERVE ST, Missoula, MT 59801
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Other Names 1

Doing Business AsShopko Pharmacy 075

Other Identifiers 11

Medicare NSC5695760120
Medicare ID-Type Unspecified5695760120
Medicaid5607892MT
Other2704408Ncpdp Number
Other0163513Wa Labor & Industry
Other0215807Wa Labor & Industry
Medicaid5607355MT
Medicaid0230469MT
Medicare PIN011002736MT
Medicaid0212030MT
Medicare ID-Type Unspecified1111590016

Other Providers at the Same Location NPPES 6

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

THOMAS R FERGUSON O.D.
Optometrist
2510 S RESERVE ST
MISSOULA, MT 59801
Missoula County (406) 721-5925
SHOPKO STORES OPERATING CO. LLC
Eyewear Supplier
2510 S RESERVE ST
MISSOULA, MT 59801
Missoula County (406) 721-4646
MRS. REBECCA KATHERINE PITT JACKSON OD
Optometrist
2510 S RESERVE ST
MISSOULA, MT 59801
Missoula County (406) 251-4579
GRETCHEN DIERKEN
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
2510 S RESERVE ST
MISSOULA, MT 59801
Missoula County (406) 721-4514
BRETT CURRIE
Pharmacist
2510 S RESERVE ST
MISSOULA, MT 59801
Missoula County (406) 721-3789
DR. GREGORY GENE ZELL O.D.
Optometrist (Corneal and Contact Management)
2510 S RESERVE ST
MISSOULA, MT 59801
Missoula County (406) 721-4646

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 1215981014. It was assigned to this organization in the NPPES registry on May 19, 2006. The provider is doing business as Shopko Pharmacy 075.

Where is Shopko Stores Operating Co LLC located?

Shopko Stores Operating Co LLC is located at 2510 S Reserve St, Missoula, MT 59801. The listed phone number is (406) 721-3789.

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 11, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.