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Shopko Stores Operating Co LLC

Community/Retail Pharmacy in Bend, OR · 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

1104878628

Verified

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Registry record

Entity type Organization (Type 2)
Legal business name Shopko Stores Operating Co LLC
Other name <Unavail>
Practice address 60 Ne Bend River Mall Dr, Bend, OR, 97701
Phone (541) 385-6076
Fax (541) 385-9209
Enumeration date May 16, 2006
Last updated in NPPES Oct 28, 2013

Taxonomy & classification

332B00000X Durable Medical Equipment & Medical Supplies Suppliers Secondary
332H00000X Eyewear Supplier Suppliers Secondary
3336C0003X Community/Retail Pharmacy Suppliers · License 1084 (OR) Primary

Authorized official

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

Other identifiers

Identifier Type State Issuer
3809956 Other - NCPDP NUMBER
278350 Medicaid OR -
278377 Medicaid OR -
000682 Medicaid OR -

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

What is a Type 2 NPI?
A Type 2 NPI identifies an organization (group practice, hospital, pharmacy, lab), while Type 1 NPIs identify individual providers. Organizations bill under their Type 2 NPI.
What type of organization is Shopko Stores Operating Co LLC?
Shopko Stores Operating Co LLC is registered in NPPES as a Community/Retail Pharmacy (its primary provider taxonomy).

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2013-10-28.