ShopKo Pharmacy 113 – Community/Retail Pharmacy, NPI 1962442392

ShopKo Pharmacy 113 is a healthcare provider. based in Lacey, Washington. specializing in Community/Retail Pharmacy. The organization holds a License No. CF00058640 (WA). The NPI Number for ShopKo Pharmacy 113 is 1962442392

Main info

Organization
Name
ShopKo Pharmacy 113
NPI
1962442392
Phone
(360) 456-4057
Address
5500 MARTIN WAY E
Authorized Official
MR. MICHAEL J BETTIGA SR. VICE PRESIDENT HEALTH SERVICES RPH
Enumeration Date
7 June 2006
Last Update Date
14 August 2008
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience59
Completeness80
Years active:20State licenses:1Digital endpointsUpdated within 12 months

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Provider Addresses for ShopKo Pharmacy 113

  • 5500, Martin Way East, Lacey, Thurston County, Washington, 98516, United States

    LACEY, WA 985166326

    Phone: (360) 456-4057

    Fax: (360) 456-0903

    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.

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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 98516)

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Reviews

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Frequently asked questions

Can I cross-check ShopKo Pharmacy 113 using NPI 1962442392?
NPI 1962442392 belongs to ShopKo Pharmacy 113; compare other details if you need extra assurance.
Is there an active status for ShopKo Pharmacy 113?
For scheduling context, ShopKo Pharmacy 113 is shown as active in the registry.
What kind of doctor is ShopKo Pharmacy 113?
ShopKo Pharmacy 113 is associated with Community/Retail Pharmacy in the directory — Clinical services aligned with this taxonomy classification.
Is ShopKo Pharmacy 113 located near Lacey?
ShopKo Pharmacy 113 currently maps to Lacey, Washington in this extract.
When was this NPI issued?
Enumeration for ShopKo Pharmacy 113 is noted as June 7, 2006 where the registry provides it.

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