Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Shopko Stores Operating Co LLC

Organization Durable Medical Equipment & Medical Supplies · NPI 1619928793

Shopko Stores Operating Co LLC is a Durable Medical Equipment & Medical Supplies in Salt Lake City, Utah. Licensed in Utah. Registered with an NPI since 2006.

Licensed in
UT
In the registry since
2006
Specialties on file
3
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

5800 S Redwood Rd
Salt Lake City, UT 84123-5327
Phone: (801) 967-5100
Fax: (801) 964-8201
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Community/Retail Pharmacy (primary) Taxonomy 3336C0003X · Licence 1313471703 (UT)
Durable Medical Equipment & Medical Supplies Taxonomy 332B00000X
Eyewear Supplier Taxonomy 332H00000X

Record details

NPI number1619928793
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michael Bettiga — Sr. Vice President Health Services · (920) 429-4297
Other names Shopko Pharmacy 085
NPI enumeratedMay 13, 2006
Last updated in NPPESJune 6, 2014
Mailing address5800 S Redwood Rd, Salt Lake City, UT 84123-5327

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