SHOPKO OPTICAL 040
NPI 1174576854
Eyewear Supplier in Sioux City, IA

Active since May 17, 2006
3025 HAMILTON BLVD, SIOUX CITY, IA 51104(712) 255-5869 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 040 NPPES

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

SHOPKO OPTICAL 040 (NPI 1174576854) is a healthcare organization registered as an eyewear supplier in Sioux City, Iowa 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

NPI1174576854
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameSHOPKO STORES OPERATING CO. LLC
Location Address3025 HAMILTON BLVDSioux City, IA 51104-2407
Mailing Address3025 Hamilton BlvdSioux City, IA 51104-2407 · (712) 255-5869
Organization SubpartNo
Authorized OfficialMichael J BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateMay 17, 2006
Last NPPES UpdateFebruary 11, 2008
NPI 1174576854 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.

3025 HAMILTON BLVD, Sioux City, IA 51104

Other Names 1

Doing Business AsShopko Optical 040

Other Identifiers 9

Other28489Medicare
Other17696Medicare
Medicare PINDF0755
Other35440Avesis
Medicare NSC5695760114IA
Medicare ID-Type Unspecified0154160094
Other014040Vip
OtherCP2230-9Eyemed
Medicare PINI17682IA

Other Providers at the Same Location NPPES 3

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

Pharmacy (Community/Retail Pharmacy)
3025 HAMILTON BLVD
SIOUX CITY, IA 51104
Optometrist
3025 HAMILTON BLVD
SIOUX CITY, IA 51104
Optometrist
3025 HAMILTON BLVD
SIOUX CITY, IA 51104

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 1174576854. It was assigned to this organization in the NPPES registry on May 17, 2006. The provider is doing business as Shopko Optical 040.

Where is Shopko Stores Operating Co. LLC located?

Shopko Stores Operating Co. LLC is located at 3025 Hamilton Blvd, Sioux City, IA 51104. The listed phone number is (712) 255-5869.

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.