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SHOPKO OPTICAL 129
NPI 1023060050
Eyewear Supplier in Spokane, WA

Active since May 17, 2006
4515 S REGAL ST, SPOKANE, WA 99223(509) 448-9686 Get Directions Write a Review

NPPES record last updated: June 5, 2009. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Shopko Optical 129 NPPES

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

SHOPKO OPTICAL 129 (NPI 1023060050) is a healthcare organization registered as an eyewear supplier in Spokane, Washington 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

NPI1023060050
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameSHOPKO STORES OPERATING CO. LLC
Location Address4515 S REGAL STSpokane, WA 99223-7938
Mailing Address4515 S Regal StSpokane, WA 99223-7938 · (509) 448-9686
Phone(509) 448-9686
Organization SubpartNo
Authorized OfficialMichael J BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateMay 17, 2006
Last NPPES UpdateJune 5, 2009
✔ NPI 1023060050 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyEyewear SupplierSuppliers
Taxonomy Code332H00000X
Definition
An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.
Also ListedOptometristTaxonomy 152W00000X
Also ListedTechnician/Technologist · OpticianTaxonomy 156FX1800X
4515 S REGAL ST, Spokane, WA 99223
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Other Names 1

Doing Business AsShopko Optical 129

Other Identifiers 13

Other10831Medicare
Medicare PINDF1015
Other014129Vip
OtherWA09203WA · Noridian Submitter Id
Other35548Avesis
Medicaid2017622WA
Medicare PING8860389WA
OtherG8855122Medicare
OtherCP2230-59Eyemed
Other42549Davis Vision
Medicaid2017218WA
Medicare ID-Type Unspecified0154160231
Medicare NSC5695760041

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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.

MS. KATHRYN AXTELL RPH
Pharmacist
4515 S REGAL ST
SPOKANE, WA 99223
Spokane County (509) 448-9585
MICHELE ALLER
Pharmacist
4515 S REGAL ST
SPOKANE, WA 99223
Spokane County (509) 448-9595
MELISSA DAY
Pharmacist
4515 S REGAL ST
SPOKANE, WA 99223
Spokane County (509) 448-9585
SHOPKO STORES OPERATING CO LLC
Pharmacy (Community/Retail Pharmacy)
4515 S REGAL ST
SPOKANE, WA 99223
Spokane County (509) 448-9585

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shopko Stores Operating Co. LLC's NPI number?

The NPI number for Shopko Stores Operating Co. LLC is 1023060050. It was assigned to this organization in the NPPES registry on May 17, 2006. The provider is doing business as Shopko Optical 129.

Where is Shopko Stores Operating Co. LLC located?

Shopko Stores Operating Co. LLC is located at 4515 S Regal St, Spokane, WA 99223. The listed phone number is (509) 448-9686.

What is Shopko Stores Operating Co. LLC's specialty?

The primary specialty registered for this NPI is Eyewear Supplier with taxonomy code 332H00000X.

When was this NPI record last updated?

The NPPES record for Shopko Stores Operating Co. LLC was last updated on June 5, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.