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SHOPKO PHARMACY 091
NPI 1750332730
Pharmacy - Community/Retail Pharmacy in Logan, UT

Active since May 13, 2006
1341 N MAIN ST, LOGAN, UT 84341(435) 753-2700(435) 753-3894 Get Directions Write a Review

NPPES record last updated: June 6, 2014. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Shopko Pharmacy 091 NPPES

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

SHOPKO PHARMACY 091 (NPI 1750332730) is a healthcare organization registered as a community/retail pharmacy in Logan, 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

NPI1750332730
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameSHOPKO STORES OPERATING CO LLC
Location Address1341 N MAIN STLogan, UT 84341-2221
Mailing Address1341 N Main StLogan, UT 84341-2221 · (435) 753-2700 · Fax (435) 753-3894
Phone(435) 753-2700
Fax(435) 753-3894
Organization SubpartNo
Authorized OfficialMichael J BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateMay 13, 2006
Last NPPES UpdateJune 6, 2014
✔ NPI 1750332730 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 UT · 1318501703
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 1318501703 (UT)
1341 N MAIN ST, Logan, UT 84341
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Other Names 1

Doing Business AsShopko Pharmacy 091

Other Identifiers 8

Medicare ID-Type Unspecified0154160155
Medicare NSC5695760044
Medicaid8533280SD
Medicaid=========008UT
Other4606894Ncpdp Number
Medicaid410985054604UT
Medicaid804040900ID
MedicaidPH246UTAK

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.

SHOPKO STORES OPERATING CO. LLC
Eyewear Supplier
1341 N MAIN ST
LOGAN, UT 84341
Cache County (435) 753-0700
DR. ALAN HASTINGS O.D.
Optometrist
1341 N MAIN ST
LOGAN, UT 84341
Cache County (435) 753-0700

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 1750332730. It was assigned to this organization in the NPPES registry on May 13, 2006. The provider is doing business as Shopko Pharmacy 091.

Where is Shopko Stores Operating Co LLC located?

Shopko Stores Operating Co LLC is located at 1341 N Main St, Logan, UT 84341. The listed phone number is (435) 753-2700.

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 June 6, 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.