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SHOPKO OPTICAL 083
NPI 1346292505
Eyewear Supplier in Sandy, UT

Active since May 16, 2006
2165 E 9400 S, SANDY, UT 84093(801) 942-7171 Get Directions Write a Review

NPPES record last updated: July 10, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Shopko Optical 083 NPPES

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

SHOPKO OPTICAL 083 (NPI 1346292505) is a healthcare organization registered as an eyewear supplier in Sandy, Utah 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

NPI1346292505
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameSHOPKO STORES OPERATING CO. LLC
Location Address2165 E 9400 SSandy, UT 84093-3201
Mailing Address2165 E 9400 SSandy, UT 84093-3201 · (801) 942-7171
Phone(801) 942-7171
Organization SubpartNo
Authorized OfficialMichael J BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateMay 16, 2006
Last NPPES UpdateJuly 10, 2008
✔ NPI 1346292505 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyEyewear SupplierSuppliers
Taxonomy Code332H00000X
Definition
An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.
Also ListedOptometristTaxonomy 152W00000X
Also ListedTechnician/Technologist · OpticianTaxonomy 156FX1800X
2165 E 9400 S, Sandy, UT 84093
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Other Names 1

Doing Business AsShopko Optical 083

Other Identifiers 10

Other17917Medicare
OtherUT04886UT · Noridian Submitter Id
Medicare ID-Type Unspecified0154160001
Medicare PINDF0852
Other42541Davis
Medicare NSC5695760046UT
Other014083Vip
Medicare PIN000058212UT
Medicaid410985054-071UT
OtherCP2230-51Eyemed

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

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

SHOPKO STORES OPERATING CO LLC
Pharmacy (Community/Retail Pharmacy)
2165 E 9400 S
SANDY, UT 84093
Salt Lake County (801) 942-8555
DR. DAVID NELSON LATER O.D.
Optometrist
2165 E 9400 S
SANDY, UT 84093
Salt Lake County (801) 942-7171

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 1346292505. It was assigned to this organization in the NPPES registry on May 16, 2006. The provider is doing business as Shopko Optical 083.

Where is Shopko Stores Operating Co. LLC located?

Shopko Stores Operating Co. LLC is located at 2165 E 9400 S, Sandy, UT 84093. The listed phone number is (801) 942-7171.

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 July 10, 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.