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SHOPKO OPTICAL 001
NPI 1346292430
Eyewear Supplier in Green Bay, WI

Active since May 17, 2006
216 S MILITARY AVE, GREEN BAY, WI 54303(920) 494-3384 Get Directions Write a Review

NPPES record last updated: February 8, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Shopko Optical 001 NPPES

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

SHOPKO OPTICAL 001 (NPI 1346292430) is a healthcare organization registered as an eyewear supplier in Green Bay, 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

NPI1346292430
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameSHOPKO STORES OPERATING CO. LLC
Location Address216 S MILITARY AVEGreen Bay, WI 54303-2498
Mailing Address216 S Military AveGreen Bay, WI 54303-2498 · (920) 494-3384
Phone(920) 494-3384
Organization SubpartNo
Authorized OfficialMichael J BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateMay 17, 2006
Last NPPES UpdateFebruary 8, 2008
✔ NPI 1346292430 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.
216 S MILITARY AVE, Green Bay, WI 54303
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Other Names 1

Doing Business AsShopko Optical 001

Other Identifiers 9

Other410985054-4001Nva
Medicare ID-Type Unspecified0154160039
Medicaid38403000WI
Medicare NSC5695760007
Other014001Vip
OtherCP2230-68Eyemed
Medicare PINDF0804
Other17634Medicare
Other42495Davis

Other Providers at the Same Location NPPES 6

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

DR. MICHELLE MARIE MUELLER O.D.
Optometrist
216 S MILITARY AVE
GREEN BAY, WI 54303
Brown County (920) 494-3384
DANIEL CHRISTOPHER TORREANO PHARMD.
Pharmacist
216 S MILITARY AVE
GREEN BAY, WI 54303
Brown County (920) 499-0895
DR. THOMAS EDWARD BOBKA OD
Optometrist
216 S MILITARY AVE
GREEN BAY, WI 54303
Brown County (920) 494-3384
MR. JAMIE MICHAEL KINJERSKI PHARMD.
Pharmacist
216 S MILITARY AVE
GREEN BAY, WI 54303
Brown County (920) 499-0895
LAWRENCE ADAM GOTTLIEB
Pharmacist
216 S MILITARY AVE
GREEN BAY, WI 54303
Brown County (920) 499-0895
SHOPKO STORES OPERATING CO LLC
Pharmacy (Community/Retail Pharmacy)
216 S MILITARY AVE
GREEN BAY, WI 54303
Brown County (920) 499-0895

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 1346292430. It was assigned to this organization in the NPPES registry on May 17, 2006. The provider is doing business as Shopko Optical 001.

Where is Shopko Stores Operating Co. LLC located?

Shopko Stores Operating Co. LLC is located at 216 S Military Ave, Green Bay, WI 54303. The listed phone number is (920) 494-3384.

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 8, 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.