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

Shopko Stores Operating Co LLC

Organization Durable Medical Equipment & Medical Supplies · NPI 1962442392

Shopko Stores Operating Co LLC is a Durable Medical Equipment & Medical Supplies in Lacey, Washington. Licensed in Washington. Registered with an NPI since 2006.

Licensed in
WA
In the registry since
2006
Specialties on file
2
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

5500 Martin Way E
Lacey, WA 98516-6326
Phone: (360) 456-4057
Fax: (360) 456-0903
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Community/Retail Pharmacy (primary) Taxonomy 3336C0003X · Licence CF00058640 (WA)
Durable Medical Equipment & Medical Supplies Taxonomy 332B00000X

Record details

NPI number1962442392
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michael Bettiga — Sr. Vice President Health Services · (920) 429-4297
Other names Shopko Pharmacy 113
NPI enumeratedJune 7, 2006
Last updated in NPPESAugust 14, 2008
Mailing address5500 Martin Way E, Lacey, WA 98516-6326

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