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SHOPKO PHARMACY 169
NPI 1235176983
Pharmacy - Community/Retail Pharmacy in Meridian, ID

Active since June 01, 2006
3499 E FAIRVIEW AVE, MERIDIAN, ID 83642(208) 884-1286(208) 884-1186 Get Directions Write a Review

NPPES record last updated: July 10, 2009. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Shopko Pharmacy 169 NPPES

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

SHOPKO PHARMACY 169 (NPI 1235176983) is a healthcare organization registered as a community/retail pharmacy in Meridian, Idaho and active in the NPI registry since June 2006. The organization lists Michael J Bettiga, Sr. Vice President Health Services, as its authorized official.

NPPES Registry Identity

NPI1235176983
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameSHOPKO STORES OPERATING CO LLC
Location Address3499 E FAIRVIEW AVEMeridian, ID 83642-5848
Mailing Address3499 E Fairview AveMeridian, ID 83642-5848 · (208) 884-1286 · Fax (208) 884-1186
Phone(208) 884-1286
Fax(208) 884-1186
Organization SubpartNo
Authorized OfficialMichael J BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateJune 1, 2006
Last NPPES UpdateJuly 10, 2009
✔ NPI 1235176983 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 ID · 2038CP
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 ListedPharmacyTaxonomy 333600000X · License 2038CP (ID)
3499 E FAIRVIEW AVE, Meridian, ID 83642
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Other Names 1

Doing Business AsShopko Pharmacy 169

Other Identifiers 5

Medicare ID-Type Unspecified0154160291
Medicare ID-Type Unspecified5695760018
Medicaid805516800ID
Medicare NSC5695760018
Other1306807Ncpdp Number

Other Providers at the Same Location NPPES 16

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

JANETTE M BECKWITH
Pharmacist
3499 E FAIRVIEW AVE
MERIDIAN, ID 83642
Ada County (208) 884-1286
TYLER CALLAHAN
Pharmacy Technician
3499 E FAIRVIEW AVE
MERIDIAN, ID 83642
Ada County (208) 605-3755
SHOPKO STORES OPERATING CO. LLC
Eyewear Supplier
3499 E FAIRVIEW AVE
MERIDIAN, ID 83642
Ada County (208) 884-1362
NATALIE TANG PHARMD
Pharmacist
3499 E FAIRVIEW AVE
MERIDIAN, ID 83642
Ada County (208) 605-3755
KELLY LYNN HANCOCK PHARMD.
Pharmacist
3499 E FAIRVIEW AVE
MERIDIAN, ID 83642
Ada County (208) 884-1286
NIKOLE LADEEN ZETTERBERG
Pharmacist
3499 E FAIRVIEW AVE
MERIDIAN, ID 83642
Ada County (818) 687-3006
ALBERTSONS LLC
Pharmacy (Community/Retail Pharmacy)
3499 E FAIRVIEW AVE
MERIDIAN, ID 83642
Ada County (208) 395-3906
DR. DAVID J SLAGOWSKI O.D.
Optometrist
3499 E FAIRVIEW AVE
MERIDIAN, ID 83642
Ada County (208) 884-1362

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 1235176983. It was assigned to this organization in the NPPES registry on June 1, 2006. The provider is doing business as Shopko Pharmacy 169.

Where is Shopko Stores Operating Co LLC located?

Shopko Stores Operating Co LLC is located at 3499 E Fairview Ave, Meridian, ID 83642. The listed phone number is (208) 884-1286.

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 July 10, 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.