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SHOPKO PHARMACY 064
NPI 1295780815
Pharmacy - Community/Retail Pharmacy in Nampa, ID

Active since May 23, 2006
2100 CALDWELL BLVD, NAMPA, ID 83651(208) 466-9616(208) 463-1724 Get Directions Write a Review

NPPES record last updated: July 25, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Shopko Pharmacy 064 NPPES

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

SHOPKO PHARMACY 064 (NPI 1295780815) is a healthcare organization registered as a community/retail pharmacy in Nampa, Idaho 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

NPI1295780815
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameSHOPKO STORES OPERATING CO LLC
Location Address2100 CALDWELL BLVDNampa, ID 83651-1510
Mailing Address2100 Caldwell BlvdNampa, ID 83651-1510 · (208) 466-9616 · Fax (208) 463-1724
Phone(208) 466-9616
Fax(208) 463-1724
Organization SubpartNo
Authorized OfficialMichael J BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateMay 23, 2006
Last NPPES UpdateJuly 25, 2014
✔ NPI 1295780815 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in ID · 2042CP
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
Also ListedPharmacyTaxonomy 333600000X · License 2042CP (ID)
2100 CALDWELL BLVD, Nampa, ID 83651
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Other Names 1

Doing Business AsShopko Pharmacy 064

Other Identifiers 6

Medicare ID-Type Unspecified1111590020
Medicaid000311800ID
Other0193994Wa Labor & Industry
Medicare NSC5695760006
Other0215801Wa Labor & Industry
Other1304524Ncpdp Number

Other Providers at the Same Location NPPES 5

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

SHOPKO STORES OPERATING CO. LLC
Eyewear Supplier
2100 CALDWELL BLVD
NAMPA, ID 83651
Canyon County (208) 466-6895
TIMOTHY F SWAIN RPH, PHARM D
Pharmacist
2100 CALDWELL BLVD
NAMPA, ID 83651
Canyon County (208) 466-9616
MR. MARK MATTHEW MCKELL O.D.
Optometrist
2100 CALDWELL BLVD
NAMPA, ID 83651
Canyon County (208) 466-6895
DR. JOY GAYLE JOHNSON O.D.
Optometrist
2100 CALDWELL BLVD
NAMPA, ID 83651
Canyon County (208) 465-5542
THOMAS JOSEPH STATZ
Pharmacist
2100 CALDWELL BLVD
NAMPA, ID 83651
Canyon County (208) 466-9616

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 1295780815. It was assigned to this organization in the NPPES registry on May 23, 2006. The provider is doing business as Shopko Pharmacy 064.

Where is Shopko Stores Operating Co LLC located?

Shopko Stores Operating Co LLC is located at 2100 Caldwell Blvd, Nampa, ID 83651. The listed phone number is (208) 466-9616.

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 25, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.