1. Home
  2. Directory
  3. Oregon
  4. Bend
  5. Eyewear Supplier
  6. NPI Profile

SHOPKO OPTICAL 093
NPI 1023069499
Eyewear Supplier in Bend, OR

Active since May 12, 2006
60 NE BEND RIVER MALL DR, BEND, OR 97701(541) 385-6079 Get Directions Write a Review

NPPES record last updated: March 19, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Shopko Optical 093 NPPES

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

SHOPKO OPTICAL 093 (NPI 1023069499) is a healthcare organization registered as an eyewear supplier in Bend, Oregon 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

NPI1023069499
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameSHOPKO STORES OPERATING CO LLC
Location Address60 NE BEND RIVER MALL DRBend, OR 97701-7528
Mailing Address60 Ne Bend River Mall DrBend, OR 97701-7528 · (541) 385-6079
Phone(541) 385-6079
Organization SubpartNo
Authorized OfficialMichael J BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateMay 12, 2006
Last NPPES UpdateMarch 19, 2008
✔ NPI 1023069499 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.
60 NE BEND RIVER MALL DR, Bend, OR 97701
Open in Google Maps ↗

Other Names 1

Doing Business AsShopko Optical 093

Other Identifiers 12

Other17679Medicarecomplete
Other42573Davis Vision
Medicaid022688OR
Medicare NSC5695760101OR
OtherCP2230-33Eyemed
Other014093Vip
Medicaid005251OR
Medicare ID-Type Unspecified0154160025
Medicare PINR134768OR
Medicare PINDF1182
Other35508Avesis
Other112254Or Medicare-noridian

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.

MR. KERST BOSMA RPH
Pharmacist
60 NE BEND RIVER MALL DR
BEND, OR 97701
Deschutes County (541) 385-6076
SHOPKO STORES OPERATING CO LLC
Pharmacy (Community/Retail Pharmacy)
60 NE BEND RIVER MALL DR
BEND, OR 97701
Deschutes County (541) 385-6076
MR. GERALD DANA RADANT RPH
Pharmacist
60 NE BEND RIVER MALL DR
BEND, OR 97701
Deschutes County (541) 385-6076
JONATHAN CARNEY
Pharmacist
60 NE BEND RIVER MALL DR
BEND, OR 97701
Deschutes County (541) 385-6076

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 1023069499. It was assigned to this organization in the NPPES registry on May 12, 2006. The provider is doing business as Shopko Optical 093.

Where is Shopko Stores Operating Co LLC located?

Shopko Stores Operating Co LLC is located at 60 NE Bend River Mall Dr, Bend, OR 97701. The listed phone number is (541) 385-6079.

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 March 19, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.