SHOPKO OPTICAL 048
NPI 1073565503
Eyewear Supplier in Norfolk, NE

Active since May 16, 2006
2005 KRENZIEN DR, NORFOLK, NE 68701(402) 379-1434 Get Directions Write a Review

NPPES record last updated: February 11, 2008. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Shopko Optical 048 NPPES

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

SHOPKO OPTICAL 048 (NPI 1073565503) is a healthcare organization registered as an eyewear supplier in Norfolk, Nebraska 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

NPI1073565503
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameSHOPKO STORES OPERATING CO. LLC
Location Address2005 KRENZIEN DRNorfolk, NE 68701-4601
Mailing Address2005 Krenzien DrNorfolk, NE 68701-4601 · (402) 379-1434
Organization SubpartNo
Authorized OfficialMichael J BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateMay 16, 2006
Last NPPES UpdateFebruary 11, 2008
NPI 1073565503 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.

2005 KRENZIEN DR, Norfolk, NE 68701

Other Names 1

Doing Business AsShopko Optical 048

Other Identifiers 11

Other007126Block
OtherCP2230-28Eyemed
Medicaid41098505421NE
Medicare NSC5695760060NE
Medicare PIN099830NE
Other17888Medicare
Other094813Medicare
Medicare ID-Type Unspecified0154160183
Other014048Vip
Other35864Davis
Medicare PINDF0848

Other Providers at the Same Location NPPES

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

Pharmacy (Community/Retail Pharmacy)
2005 KRENZIEN DR
NORFOLK, NE 68701

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 1073565503. It was assigned to this organization in the NPPES registry on May 16, 2006. The provider is doing business as Shopko Optical 048.

Where is Shopko Stores Operating Co. LLC located?

Shopko Stores Operating Co. LLC is located at 2005 Krenzien Dr, Norfolk, NE 68701. The listed phone number is (402) 379-1434.

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 February 11, 2008. NPI Profile syncs with the weekly NPPES data releases published by CMS.