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SHOPKO OPTICAL 057
NPI 1376595439
Eyewear Supplier in Winona, MN

Active since May 17, 2006
405 COTTONWOOD DR, WINONA, MN 55987(507) 452-6175 Get Directions Write a Review

NPPES record last updated: April 15, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Shopko Optical 057 NPPES

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

SHOPKO OPTICAL 057 (NPI 1376595439) is a healthcare organization registered as an eyewear supplier in Winona, 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

NPI1376595439
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameSHOPKO STORES OPERATING CO. LLC
Location Address405 COTTONWOOD DRWinona, MN 55987-1914
Mailing Address405 Cottonwood DrWinona, MN 55987-1914 · (507) 452-6175
Phone(507) 452-6175
Organization SubpartNo
Authorized OfficialMichael J BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateMay 17, 2006
Last NPPES UpdateApril 15, 2008
✔ NPI 1376595439 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.
405 COTTONWOOD DR, Winona, MN 55987
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Other Names 1

Doing Business AsShopko Optical 057

Other Identifiers 15

Other42491Davis
Other213121-18Eyemed
Other26679SHMn Ma First Plan Of Mn
Other34965Mn Health Partners
Other35482Avesis
Medicare PINDF0849
Medicare ID-Type Unspecified1111590045
Medicare PINC04276
Other20019120527Mn Ma Primewest Health
Other35584Avesis
Other47522SHMn Ma First Plan Of Mn
Other17828Medicare
Other410985054-4057National Vision Admin.
Other014057Vip
Medicare NSC5695760091MN

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.

DR. THOMAS LEE DAHLBY O.D.
Optometrist
405 COTTONWOOD DR
WINONA, MN 55987
Winona County (507) 452-6175
CATHERINE TESMER RPH
Pharmacist
405 COTTONWOOD DR
WINONA, MN 55987
Winona County (507) 452-1244
SHOPKO STORES OPERATING CO LLC
Pharmacy (Community/Retail Pharmacy)
405 COTTONWOOD DR
WINONA, MN 55987
Winona County (507) 452-1244

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 1376595439. It was assigned to this organization in the NPPES registry on May 17, 2006. The provider is doing business as Shopko Optical 057.

Where is Shopko Stores Operating Co. LLC located?

Shopko Stores Operating Co. LLC is located at 405 Cottonwood Dr, Winona, MN 55987. The listed phone number is (507) 452-6175.

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 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.