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SHOPKO OPTICAL 073
NPI 1396797486
Eyewear Supplier in Union Gap, WA

Active since May 17, 2006
2530 RUDKIN RD, UNION GAP, WA 98903(509) 248-9833 Get Directions Write a Review

NPPES record last updated: June 5, 2009. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Shopko Optical 073 NPPES

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

SHOPKO OPTICAL 073 (NPI 1396797486) is a healthcare organization registered as an eyewear supplier in Union Gap, Washington 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

NPI1396797486
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameSHOPKO STORES OPERATING CO. LLC
Location Address2530 RUDKIN RDUnion Gap, WA 98903-1632
Mailing Address2530 Rudkin RdUnion Gap, WA 98903-1632 · (509) 248-9833
Phone(509) 248-9833
Organization SubpartNo
Authorized OfficialMichael J BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateMay 17, 2006
Last NPPES UpdateJune 5, 2009
✔ NPI 1396797486 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
2530 RUDKIN RD, Union Gap, WA 98903
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Other Names 1

Doing Business AsShopko Optical 073

Other Identifiers 12

Medicare ID-Type Unspecified1111590012
Medicare PING8860390WA
OtherWA09209WA · Noridian Submitter Id
Other213121-30Eyemed
Other35549Avesis
OtherG8854795Medicare
Other014073Vip
Medicaid2029924WA
Medicaid2200004WA
Medicare PINDF1015
Other17672Medicare
Medicare NSC5695760126WA

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 4

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)
2530 RUDKIN RD
UNION GAP, WA 98903
Yakima County (509) 248-9567
LLOYD D SMITH RPH
Pharmacist
2530 RUDKIN RD
UNION GAP, WA 98903
Yakima County (509) 248-9567
MR. PHILIP ANDREW JOHNSTON
Pharmacist
2530 RUDKIN RD
UNION GAP, WA 98903
Yakima County (509) 248-9567
DEBORAH ANN PARRIES RPH
Pharmacist
2530 RUDKIN RD
UNION GAP, WA 98903
Yakima County (509) 248-9567

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 1396797486. It was assigned to this organization in the NPPES registry on May 17, 2006. The provider is doing business as Shopko Optical 073.

Where is Shopko Stores Operating Co. LLC located?

Shopko Stores Operating Co. LLC is located at 2530 Rudkin Rd, Union Gap, WA 98903. The listed phone number is (509) 248-9833.

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 June 5, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.