Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum

Shopko Stores Operating Co LLC

Community/Retail Pharmacy in Boise, 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

1326085077

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 2655 Broadway Ave, Boise, ID, 83706

Phone (208) 345-8728

Fax (208) 343-6591

Enumeration date Jun 1, 2006

Last updated in NPPES Jul 25, 2014

Taxonomy & classification

332B00000X Durable Medical Equipment & Medical Supplies Suppliers Secondary

332H00000X Eyewear Supplier Suppliers Secondary

333600000X Pharmacy Suppliers · License 2041CP (ID) Secondary

3336C0003X Community/Retail Pharmacy Suppliers · License 2041CP (ID) Primary

Authorized official

Name Michael Bettiga

Title Sr. Vice President Health Services

Phone (920) 429-4297

Other identifiers

Identifier	Type	State	Issuer
1305108	Other	-	NCPDP NUMBER
000123000	Medicaid	ID	-

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

How current is this record?

Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2014-07-25. Verify at npiregistry.cms.hhs.gov.

Where is Shopko Stores Operating Co LLC located?

The practice location on file with NPPES is in Boise, ID.

Providers at this address

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Shopko Stores Operating Co. LLC Eyewear Supplier · Boise, ID NPI 1477505485

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2014-07-25.