SHOPKO OPTICAL 114
NPI 1295788818
Eyewear Supplier in Duluth, MN

Active since May 17, 2006
801 W CENTRAL ENTRANCE, DULUTH, MN 55811(218) 727-7163 Get Directions Write a Review

NPPES record last updated: April 15, 2008. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Shopko Optical 114 NPPES

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

SHOPKO OPTICAL 114 (NPI 1295788818) is a healthcare organization registered as an eyewear supplier in Duluth, Minnesota 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

NPI1295788818
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameSHOPKO STORES OPERATING CO. LLC
Location Address801 W CENTRAL ENTRANCEDuluth, MN 55811-5468
Mailing Address801 W Central EntranceDuluth, MN 55811-5468 · (218) 727-7163
Organization SubpartNo
Authorized OfficialMichael J BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateMay 17, 2006
Last NPPES UpdateApril 15, 2008
NPI 1295788818 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.

801 W CENTRAL ENTRANCE, Duluth, MN 55811

Other Names 1

Doing Business AsShopko Optical 114

Other Identifiers 13

Other3C268SHMn Ma First Plan Of Mn
Other410985054-4114National Vision Admin.
Medicare PINDF0849
OtherCP2230-18Eyemed
Other42522Davis
Medicare PINC04276
Other014114Vip
Other3C266SHMn Blue Plus Care
Other36060Mn Health Partners
Medicare ID-Type Unspecified0154160161
Other17833Medicare
Other03092036207Mn Ma Primewest Health
Medicare NSC5695760093MN

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.

Optometrist
801 W CENTRAL ENTRANCE
DULUTH, MN 55811
Optometrist
801 W CENTRAL ENTRANCE
DULUTH, MN 55811
Pharmacist
801 W CENTRAL ENTRANCE
DULUTH, MN 55811
Pharmacy (Community/Retail Pharmacy)
801 W CENTRAL ENTRANCE
DULUTH, MN 55811

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 1295788818. It was assigned to this organization in the NPPES registry on May 17, 2006. The provider is doing business as Shopko Optical 114.

Where is Shopko Stores Operating Co. LLC located?

Shopko Stores Operating Co. LLC is located at 801 W Central Entrance, Duluth, MN 55811. The listed phone number is (218) 727-7163.

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 April 15, 2008. NPI Profile syncs with the weekly NPPES data releases published by CMS.