SHOPKO OPTICAL 609
NPI 1285912535
Eyewear Supplier in Keil, WI

Active since August 03, 2011
1120 STATE ROAD 67, KEIL, WI 53042(920) 894-3604 Get Directions Write a Review

NPPES record last updated: November 3, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Shopko Optical 609 NPPES

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

SHOPKO OPTICAL 609 (NPI 1285912535) is a healthcare organization registered as an eyewear supplier in Keil, Wisconsin and active in the NPI registry since August 2011. The organization lists Michael Bettiga, Executive Vice President & Coo, as its authorized official.

NPPES Registry Identity

NPI1285912535
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameSHOPKO STORES OPERATING CO LLC
Location Address1120 STATE ROAD 67Keil, WI 53042-1630
Mailing Address1120 State Road 67Keil, WI 53042-1630 · (920) 894-3604
Organization SubpartNo
Authorized OfficialMichael BettigaExecutive Vice President & Coo · (920) 429-4297
Enumeration DateAugust 3, 2011
Last NPPES UpdateNovember 3, 2011
NPI 1285912535 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.
1120 STATE ROAD 67, Keil, WI 53042

Other Names 1

Doing Business AsShopko Optical 609

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.

Pharmacist
1120 STATE ROAD 67
KIEL, WI 53042
Pharmacy (Community/Retail Pharmacy)
1120 STATE ROAD 67
KIEL, WI 53042
Pharmacist
1120 STATE ROAD 67
KIEL, WI 53042

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 1285912535. It was assigned to this organization in the NPPES registry on August 3, 2011. The provider is doing business as Shopko Optical 609.

Where is Shopko Stores Operating Co LLC located?

Shopko Stores Operating Co LLC is located at 1120 State Road 67, Keil, WI 53042. The listed phone number is (920) 894-3604.

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 November 3, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.