ShopKo Pharmacy 111 – Community/Retail Pharmacy, NPI 1639121155

ShopKo Pharmacy 111 is a healthcare provider. based in Salem, Oregon. specializing in Community/Retail Pharmacy. The organization holds a License No. 1193 (OR). The NPI Number for ShopKo Pharmacy 111 is 1639121155

Main info

Organization
Name
ShopKo Pharmacy 111
NPI
1639121155
Phone
(503) 371-6830
Address
1230 LANCASTER DR SE
Authorized Official
MR. RUSSELL STEINHORST SVP CHIEF FINANCIAL OFFICER
Enumeration Date
16 May 2006
Last Update Date
6 April 2016
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness80
Years active:20State licenses:1Digital endpointsUpdated within 12 months

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Provider Addresses for ShopKo Pharmacy 111

  • Vacant, 1230, Lancaster Drive Southeast, Salem, Marion County, Oregon, 97317, United States

    SALEM, OR 973175800

    Phone: (503) 371-6830

    Fax: (503) 371-8159

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 97317)

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Reviews

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Frequently asked questions

What is the 10-digit NPI for ShopKo Pharmacy 111?
ShopKo Pharmacy 111 — NPI 1639121155 — is the standard way to identify this listing.
Can I rely on ShopKo Pharmacy 111 being an active provider?
As of the registry snapshot, ShopKo Pharmacy 111 is marked active.
What is ShopKo Pharmacy 111's specialty?
The listing groups ShopKo Pharmacy 111 with Community/Retail Pharmacy. Clinical services aligned with this taxonomy classification.
Where is ShopKo Pharmacy 111 based?
ShopKo Pharmacy 111 is tied to Salem, Oregon in the data we show; additional addresses may exist on the full record.
Is the information about ShopKo Pharmacy 111 up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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