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Shopko Stores Operating Co LLC

Community/Retail Pharmacy in Spanish Fork, UT · enumerated 2006 · authorized official Michael Bettiga, Sr. Vice President Health Services.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1053362038

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Registry record

Entity type Organization (Type 2)
Legal business name Shopko Stores Operating Co LLC
Other name <Unavail>
Practice address 955 N Main St, Spanish Fork, UT, 84660
Phone (801) 798-3529
Fax (801) 798-1182
Enumeration date May 13, 2006
Last updated in NPPES Jun 6, 2014

Taxonomy & classification

332B00000X Durable Medical Equipment & Medical Supplies Suppliers Secondary
332H00000X Eyewear Supplier Suppliers Secondary
3336C0003X Community/Retail Pharmacy Suppliers · License 1327511703 (UT) Primary

Authorized official

Name Michael Bettiga
Title Sr. Vice President Health Services
Phone (920) 429-4297

Other identifiers

Identifier Type State Issuer
410985054506 Medicaid UT -
4607341 Other - NCPDP NUMBER

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

Where is Shopko Stores Operating Co LLC located?
The practice location on file with NPPES is in Spanish Fork, UT.
How current is this record?
Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2014-06-06. Verify at npiregistry.cms.hhs.gov.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2014-06-06.