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Shopko Stores Operating Co LLC

Community/Retail Pharmacy in Idaho Falls, ID · 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

1255386975

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Registry record

Entity type Organization (Type 2)
Legal business name Shopko Stores Operating Co LLC
Other name <Unavail>
Practice address 800 E 17th St, Idaho Falls, ID, 83404
Phone (208) 522-3572
Fax (208) 522-3066
Enumeration date May 23, 2006
Last updated in NPPES Mar 21, 2014

Taxonomy & classification

332B00000X Durable Medical Equipment & Medical Supplies Suppliers Secondary
332H00000X Eyewear Supplier Suppliers Secondary
333600000X Pharmacy Suppliers · License 2040CP (ID) Secondary
3336C0003X Community/Retail Pharmacy Suppliers · License 2040CP (ID) Primary

Authorized official

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

Other identifiers

Identifier Type State Issuer
000311500 Medicaid ID -
1304512 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

Who is the authorized official for Shopko Stores Operating Co LLC?
NPPES lists Michael Bettiga (Sr. Vice President Health Services) as the authorized official for this organization.
What is the NPI number for Shopko Stores Operating Co LLC?
The NPI for Shopko Stores Operating Co LLC is 1255386975, a Type 2 (organization) record in the CMS NPPES registry.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2014-03-21.