NPI age
19 years
Enumerated 2006-06-01
● Active Type 2 · Organization
Shopko Stores Operating Co Llc
Shopko Stores Operating Co Llc is 1 of 397 pharmacy organizations in Idaho.
Primary specialty
Pharmacy
Plus 3 secondary
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Bettiga
SR. Vice President Health Services
Last NPPES update
2014-06-06
Source: monthly bulk 2026-05
How this organization compares
Across 397 active pharmacy providers in Idaho.
NPI age
19 years
≈ at median (19 yr)
Practice locations
1
0 secondary on file
Subspecialties
3
In the 70% of peers with subspecialties
NPI lifetime · 2006 → 2026
2006-06Enumerated in NPPES
2006
2026
Where they practice
Primary practice location
4215 Yellowstone Ave
Chubbuck, ID 832022419
Mailing address
4215 Yellowstone Ave
Chubbuck, ID 832022419
Authorized official
Michael J Bettiga, RPH
SR. Vice President Health Services
📞 9204294297
Individual providers at this organization
4 individual providers on file at this primary practice address.
- Kirsten Blair, RPH Pharmacist NPI 1912424375
- Melissa Herzog, PHARMD Pharmacist NPI 1396000121
- Stephen Schiers, RPH Pharmacist NPI 1033460647
- Aime Taylor, PHARMD Pharmacist NPI 1225391436
Specialties
-
Pharmacy PrimaryA 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...
-
Durable Medical Equipment & Medical SuppliesA supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.
-
Eyewear SupplierAn organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.
-
PharmacyA facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 000123300 | |
| 01 | 1304550 | NCPDP NUMBER |
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
ShopKo Pharmacy 063
Practice context
Multi-provider organization. 4 individual providers on file at this primary address.
Provyx · Custom healthcare lists
Need all 397 Pharmacy providers in Idaho?
Get the full list as a CSV with verified work emails, direct phones, and LinkedIn URLs.
Request a quote →How to verify this organization
- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.