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SHOPKO PHARMACY 113
NPI 1962442392
Pharmacy - Community/Retail Pharmacy in Lacey, WA

Active since June 07, 2006
5500 MARTIN WAY E, LACEY, WA 98516(360) 456-4057(360) 456-0903 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 113 NPPES

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

SHOPKO PHARMACY 113 (NPI 1962442392) is a healthcare organization registered as a community/retail pharmacy in Lacey, Washington 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

NPI1962442392
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameSHOPKO STORES OPERATING CO LLC
Location Address5500 MARTIN WAY ELacey, WA 98516-6326
Mailing Address5500 Martin Way ELacey, WA 98516-6326 · (360) 456-4057 · Fax (360) 456-0903
Phone(360) 456-4057
Fax(360) 456-0903
Organization SubpartNo
Authorized OfficialMichael J BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateJune 7, 2006
Last NPPES UpdateAugust 14, 2008
✔ NPI 1962442392 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 WA · CF00058640
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
5500 MARTIN WAY E, Lacey, WA 98516
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Other Names 1

Doing Business AsShopko Pharmacy 113

Other Identifiers 6

Other0047611Wa Labor & Industry
Medicare ID-Type Unspecified0154160170
Medicare NSC5695760115
Other4923175Ncpdp Number
Other0215810Wa Labor & Industry
Medicaid0006013270WA

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.

SHOPKO STORES OPERATING CO. LLC
Eyewear Supplier
5500 MARTIN WAY E
LACEY, WA 98516
Thurston County (360) 456-4532
MR. GEORGE CHRISTIAN WANG PHARMACIST
Pharmacist
5500 MARTIN WAY E
LACEY, WA 98516
Thurston County (360) 456-4057
MICHELLE TERI KAUTZMANN
Pharmacist
5500 MARTIN WAY E
LACEY, WA 98516
Thurston County (360) 456-4057
MR. KENNETH R PETERSEN RPH
Pharmacist
5500 MARTIN WAY E
LACEY, WA 98516
Thurston County (360) 456-4057

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 1962442392. It was assigned to this organization in the NPPES registry on June 7, 2006. The provider is doing business as Shopko Pharmacy 113.

Where is Shopko Stores Operating Co LLC located?

Shopko Stores Operating Co LLC is located at 5500 Martin Way E, Lacey, WA 98516. The listed phone number is (360) 456-4057.

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 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.