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SHOPKO PHARMACY 084
NPI 1669423737
Pharmacy - Community/Retail Pharmacy in West Jordan, UT

Active since May 13, 2006
1553 W 9000 S, WEST JORDAN, UT 84088(801) 562-5400(801) 255-5669 Get Directions Write a Review

NPPES record last updated: March 5, 2014. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Shopko Pharmacy 084 NPPES

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

SHOPKO PHARMACY 084 (NPI 1669423737) is a healthcare organization registered as a community/retail pharmacy in West Jordan, 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

NPI1669423737
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameSHOPKO STORES OPERATING CO LLC
Location Address1553 W 9000 SWest Jordan, UT 84088-9219
Mailing Address1553 W 9000 SWest Jordan, UT 84088-9219 · (801) 562-5400 · Fax (801) 255-5669
Phone(801) 562-5400
Fax(801) 255-5669
Organization SubpartNo
Authorized OfficialMichael J BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateMay 13, 2006
Last NPPES UpdateMarch 5, 2014
✔ NPI 1669423737 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 · 1313331703
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
1553 W 9000 S, West Jordan, UT 84088
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Other Names 1

Doing Business AsShopko Pharmacy 084

Other Identifiers 5

Medicare ID-Type Unspecified0154160002
Medicare NSC5695760047
Medicaid410985054022UT
Medicaid=========001UT
Other4606705Ncpdp Number

Other Providers at the Same Location NPPES 4

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

DR. JASON EDWARD HOLMES O.D.
Optometrist
1553 W 9000 S
WEST JORDAN, UT 84088
Salt Lake County (801) 561-7300
DR. RYAN PAUL PETERSON DO
Family Medicine
1553 W 9000 S
WEST JORDAN, UT 84088
Salt Lake County (801) 563-0300
DR. RYAN DEAN SWENSEN PHARM.D
Pharmacist
1553 W 9000 S
WEST JORDAN, UT 84088
Salt Lake County (801) 562-5400
SHOPKO STORES OPERATING CO. LLC
Eyewear Supplier
1553 W 9000 S
WEST JORDAN, UT 84088
Salt Lake County (801) 561-7300

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 1669423737. It was assigned to this organization in the NPPES registry on May 13, 2006. The provider is doing business as Shopko Pharmacy 084.

Where is Shopko Stores Operating Co LLC located?

Shopko Stores Operating Co LLC is located at 1553 W 9000 S, West Jordan, UT 84088. The listed phone number is (801) 562-5400.

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 March 5, 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.