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SHOPKO OPTICAL 042
NPI 1235181298
Eyewear Supplier in Oshkosh, WI

Active since May 17, 2006
1300 S KOELLER ST, OSHKOSH, WI 54902(920) 426-5730 Get Directions Write a Review

NPPES record last updated: February 11, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Shopko Optical 042 NPPES

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

SHOPKO OPTICAL 042 (NPI 1235181298) is a healthcare organization registered as an eyewear supplier in Oshkosh, Wisconsin 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

NPI1235181298
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameSHOPKO STORES OPERATING CO. LLC
Location Address1300 S KOELLER STOshkosh, WI 54902-6169
Mailing Address1300 S Koeller StOshkosh, WI 54902-6169 · (920) 426-5730
Phone(920) 426-5730
Organization SubpartNo
Authorized OfficialMichael J BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateMay 17, 2006
Last NPPES UpdateFebruary 11, 2008
✔ NPI 1235181298 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.
1300 S KOELLER ST, Oshkosh, WI 54902
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Other Names 1

Doing Business AsShopko Optical 042

Other Identifiers 10

Other42595Davis
Other410985054-4042Nva
Medicare PINDF0804
Medicare ID-Type Unspecified0154160203
Medicare NSC5695760125WI
Other35722Avesis
Other17653Medicare
Other014042Vip
OtherCP2230-85Eyemed
Medicaid38425700WI

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. DANA JON KLEVELAND RPH
Pharmacist
1300 S KOELLER ST
OSHKOSH, WI 54902
Winnebago County (920) 426-5770
MR. LUKE MITTELSTAEDT
Pharmacist
1300 S KOELLER ST
OSHKOSH, WI 54902
Winnebago County (920) 426-5770
BRUCE D ROGERS RPH
Pharmacist
1300 S KOELLER ST
OSHKOSH, WI 54902
Winnebago County (920) 426-5770
SHOPKO STORES OPERATING CO LLC
Pharmacy (Community/Retail Pharmacy)
1300 S KOELLER ST
OSHKOSH, WI 54902
Winnebago County (920) 426-5770

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 1235181298. It was assigned to this organization in the NPPES registry on May 17, 2006. The provider is doing business as Shopko Optical 042.

Where is Shopko Stores Operating Co. LLC located?

Shopko Stores Operating Co. LLC is located at 1300 S Koeller St, Oshkosh, WI 54902. The listed phone number is (920) 426-5730.

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 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.