SHOPKO OPTICAL 178
NPI 1316108376
Eyewear Supplier in Sussex, WI

Active since June 23, 2008
N66 W25201 CTH V V, SUSSEX, WI 53089(262) 820-2611 Get Directions Write a Review

NPPES record last updated: September 10, 2008. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Shopko Optical 178 NPPES

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

SHOPKO OPTICAL 178 (NPI 1316108376) is a healthcare organization registered as an eyewear supplier in Sussex, Wisconsin and active in the NPI registry since June 2008. The organization lists Michael Bettiga, Sr. Vice President Health Services, as its authorized official.

NPPES Registry Identity

NPI1316108376
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameSHOPKO STORES OPERATING CO LLC
Location AddressN66 W25201 CTH V VSussex, WI 53089
Mailing AddressN66 W25201 Cth V VSussex, WI 53089
Organization SubpartNo
Authorized OfficialMichael BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateJune 23, 2008
Last NPPES UpdateSeptember 10, 2008
NPI 1316108376 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.

N66 W25201 CTH V V, Sussex, WI 53089

Other Names 1

Doing Business AsShopko Optical 178

Other Identifiers 2

Medicare NSC5695760142
Medicaid38461500WI

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 1316108376. It was assigned to this organization in the NPPES registry on June 23, 2008. The provider is doing business as Shopko Optical 178.

Where is Shopko Stores Operating Co LLC located?

Shopko Stores Operating Co LLC is located at N66 W25201 Cth V V, Sussex, WI 53089. The listed phone number is (262) 820-2611.

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 September 10, 2008. NPI Profile syncs with the weekly NPPES data releases published by CMS.