SHOPKO OPTICAL 016
NPI 1013969336
Eyewear Supplier in Escanaba, MI

Active since May 16, 2006
2530 1ST AVE N, ESCANABA, MI 49829(906) 786-2295 Get Directions Write a Review

NPPES record last updated: February 11, 2008. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Shopko Optical 016 NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHOPKO OPTICAL 016 (NPI 1013969336) is a healthcare organization registered as an eyewear supplier in Escanaba, Michigan and active in the NPI registry since May 2006. The organization lists Michael J Bettiga, Sr. Vice President Health Services, as its authorized official.

NPPES Registry Identity

NPI1013969336
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameSHOPKO STORES OPERATING CO. LLC
Location Address2530 1ST AVE NEscanaba, MI 49829-1390
Mailing Address2530 1st Ave NEscanaba, MI 49829-1390 · (906) 786-2295
Organization SubpartNo
Authorized OfficialMichael J BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateMay 16, 2006
Last NPPES UpdateFebruary 11, 2008
NPI 1013969336 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyEyewear SupplierSuppliers
Taxonomy Code332H00000X
Definition

An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.

2530 1ST AVE N, Escanaba, MI 49829

Other Names 1

Doing Business AsShopko Optical 016

Other Identifiers 11

Other0P06330Medicare
Medicare ID-Type Unspecified1111590049
Medicare PINDF0754
Other411740865-4016Nva
Medicare NSC5695760033MI
Other42600Davis
Other17875Medicare
Medicare PIN0P32290
Other014016Vip
Other35462Avesis
Other213121-9Eyemed

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Optometrist
2530 1ST AVE N
ESCANABA, MI 49829
Nurse Practitioner (Family)
2530 1ST AVE N
ESCANABA, MI 49829
Nurse Practitioner
2530 1ST AVE N
ESCANABA, MI 49829
Pharmacy (Community/Retail Pharmacy)
2530 1ST AVE N
ESCANABA, MI 49829

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1013969336, enumerated as an "organization" on May 16, 2006.

The provider is located at 2530 1ST AVE N ESCANABA, MI 49829 and the phone number is (906) 786-2295.

Eyewear Supplier with taxonomy code 332H00000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.