SHOPKO PHARMACY 096
NPI 1659316107
Pharmacy - Community/Retail Pharmacy in Redding, CA

NPI Status: Active since June 18, 2006

Contact Information

55 LAKE BLVD
REDDING, CA
ZIP 96003
Phone: (530) 241-0713
Fax: (530) 241-1447

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  • Organization
  • Pharmacy
  • Community/Retail Pharmacy

About SHOPKO PHARMACY 096

This page provides the complete NPI Profile along with additional information for Shopko Pharmacy 096, a provider established in Redding, California operating as a Pharmacy, focusing in community/retail pharmacy . The healthcare provider is registered in the NPI registry with number 1659316107 assigned on June 2006. The practitioner's primary taxonomy code is 3336C0003X with license number PHY47484 (CA). The provider is registered as an organization and their NPI record was last updated 17 years ago. The provider's is doing business as Shopko Pharmacy 096. The authorized official of this NPI record is Mr. Michael J Bettiga Rph (Sr. Vice President Health Services)

NPI
1659316107
Provider Legal Name
SHOPKO STORES OPERATING CO LLC
Other Organization Name
SHOPKO PHARMACY 096
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
55 LAKE BLVD REDDING, CA 96003
Location Phone
(530) 241-0713
Location Fax
(530) 241-1447
Mailing Address
55 LAKE BLVD REDDING, CA 96003
Mailing Phone
(530) 241-0713
Mailing Fax
(530) 241-1447
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
06-18-2006
Last Update Date
08-14-2008
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Pharmacy Community/Retail Pharmacy

Taxonomy Code
3336C0003X
Type
Suppliers
License No.
PHY47484
License State
CA
Taxonomy Description
A 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 dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MR. MICHAEL J BETTIGA RPH

Authorized Official Title
SR. VICE PRESIDENT HEALTH SERVICES
Authorized Official Phone
(920) 429-4297

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
0598194OTHER (01)NCPDP NUMBER
QN4PHA474840MEDICAID (05)CA 
0154160117MEDICARE ID-TYPE UNSPECIFIED (04) 
1ZXPHA358300MEDICAID (05)CA 
MFGPHA376480MEDICAID (05)CA 
PHA474840MEDICAID (05)CA 
PHA376480MEDICAID (05)CA 
5695760129MEDICARE NSC (07) 

Reviews for SHOPKO PHARMACY 096

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1659316107
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
26109611210
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 6 + 1 + 0 + 9 + 6 + 1 + 1 + 2 + 1 + 0 + 24 = 53
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 53 = 77

The NPI number 1659316107 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 2 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1245525153 SCOTT R ROSSOW RPH
Individual
Pharmacist55 LAKE BLVD SHOPKO PHARMACY 096
REDDING, CA 96003
(530) 241-0713
1811310089 LORI LEE AARON CPHT
Individual
Pharmacy Technician55 LAKE BLVD
REDDING, CA 96003
(530) 241-0713

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1659316107, enumerated in the NPI registry as an "organization" on June 18, 2006

The provider is located at 55 Lake Blvd Redding, Ca 96003 and the phone number is (530) 241-0713

This medical organization specializes in Pharmacy with taxonomy code 3336C0003X with a focus in Community/Retail Pharmacy

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

This NPI record was last updated on June 18, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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