1. Home
  2. Directory
  3. Utah
  4. Riverdale
  5. Pharmacy
  6. NPI Profile

SHOPKO PHARMACY 109
NPI 1952352932
Pharmacy - Community/Retail Pharmacy in Riverdale, UT

Active since May 13, 2006
4060 RIVERDALE RD, RIVERDALE, UT 84405(801) 392-6800(801) 392-5389 Get Directions Write a Review

NPPES record last updated: August 14, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Shopko Pharmacy 109 NPPES

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

SHOPKO PHARMACY 109 (NPI 1952352932) is a healthcare organization registered as a community/retail pharmacy in Riverdale, 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

NPI1952352932
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameSHOPKO STORES OPERATING CO LLC
Location Address4060 RIVERDALE RDRiverdale, UT 84405-1518
Mailing Address4060 Riverdale RdRiverdale, UT 84405-1518 · (801) 392-6800 · Fax (801) 392-5389
Phone(801) 392-6800
Fax(801) 392-5389
Organization SubpartNo
Authorized OfficialMichael J BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateMay 13, 2006
Last NPPES UpdateAugust 14, 2008
✔ NPI 1952352932 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 UT · 1327651703
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
4060 RIVERDALE RD, Riverdale, UT 84405
Open in Google Maps ↗

Other Names 1

Doing Business AsShopko Pharmacy 109

Other Identifiers 5

Medicare ID-Type Unspecified0154160112
Other4607353Ncpdp Number
Medicaid=========013UT
Medicare NSC5695760037
Medicaid410985054201UT

Other Providers at the Same Location NPPES

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

SHOPKO STORES OPERATING CO. LLC
Eyewear Supplier
4060 RIVERDALE RD
RIVERDALE, UT 84405
Weber County (801) 392-4300

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 1952352932. It was assigned to this organization in the NPPES registry on May 13, 2006. The provider is doing business as Shopko Pharmacy 109.

Where is Shopko Stores Operating Co LLC located?

Shopko Stores Operating Co LLC is located at 4060 Riverdale Rd, Riverdale, UT 84405. The listed phone number is (801) 392-6800.

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 14, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.