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SHOPKO OPTICAL 608
NPI 1376821629
Eyewear Supplier in Brillion, WI

Active since August 03, 2011
1010 W RYAN ST, BRILLION, WI 54110(920) 756-2640 Get Directions Write a Review

NPPES record last updated: December 9, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Shopko Optical 608 NPPES

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

SHOPKO OPTICAL 608 (NPI 1376821629) is a healthcare organization registered as an eyewear supplier in Brillion, Wisconsin and active in the NPI registry since August 2011. The organization lists Michael Bettiga, Executive Vice President & Coo, as its authorized official.

NPPES Registry Identity

NPI1376821629
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameSHOPKO STORES OPERATING CO LLC
Location Address1010 W RYAN STBrillion, WI 54110-0000
Mailing Address1010 W Ryan StBrillion, WI 54110-0000
Phone(920) 756-2640
Organization SubpartNo
Authorized OfficialMichael BettigaExecutive Vice President & Coo · (920) 429-4297
Enumeration DateAugust 3, 2011
Last NPPES UpdateDecember 9, 2011
✔ NPI 1376821629 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.
1010 W RYAN ST, Brillion, WI 54110
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Other Names 1

Doing Business AsShopko Optical 608

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.

MR. MARK ALAN RYSTICKEN RPH
Pharmacist
1010 W RYAN ST
BRILLION, WI 54110
Calumet County (920) 756-2640
MICHAEL J MICKSCH RPH
Pharmacist
1010 W RYAN ST
BRILLION, WI 54110
Calumet County (920) 756-2640
SHOPKO STORES OPERATING CO LLC
Pharmacy (Community/Retail Pharmacy)
1010 W RYAN ST
BRILLION, WI 54110
Calumet County (920) 429-4243

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 1376821629. It was assigned to this organization in the NPPES registry on August 3, 2011. The provider is doing business as Shopko Optical 608.

Where is Shopko Stores Operating Co LLC located?

Shopko Stores Operating Co LLC is located at 1010 W Ryan St, Brillion, WI 54110. The listed phone number is (920) 756-2640.

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 December 9, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.