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SHOPKO OPTICAL 059
NPI 1457304024
Eyewear Supplier in Fairmont, MN

Active since May 18, 2006
1001 HIGHWAY 15 S, FAIRMONT, MN 56031(507) 238-9490 Get Directions Write a Review

NPPES record last updated: April 15, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Shopko Optical 059 NPPES

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

SHOPKO OPTICAL 059 (NPI 1457304024) is a healthcare organization registered as an eyewear supplier in Fairmont, 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

NPI1457304024
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameSHOPKO STORES OPERATING CO. LLC
Location Address1001 HIGHWAY 15 SFairmont, MN 56031-4456
Mailing Address1001 Highway 15 SFairmont, MN 56031-4456 · (507) 238-9490
Phone(507) 238-9490
Organization SubpartNo
Authorized OfficialMichael J BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateMay 18, 2006
Last NPPES UpdateApril 15, 2008
✔ NPI 1457304024 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.
1001 HIGHWAY 15 S, Fairmont, MN 56031
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Other Names 1

Doing Business AsShopko Optical 059

Other Identifiers 13

Other3C391SHMn Ma First Plan Of Mn
OtherCP2230-19Eyemed
Other03092036205Mn Ma Primewest Health
Other35469Avesis
Medicare PINDF0849
Other014059Vip
Medicare ID-Type Unspecified0154160023
Other36058Mn Health Partners
Other17830Medicare
Other3C159SHMn Ma First Plan Of Mn
Other42493Davis
Medicare NSC5695760095MN
Medicare PINC04276

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.

KARMEN DATHER RPH
Pharmacist
1001 HIGHWAY 15 S
FAIRMONT, MN 56031
Martin County (507) 238-9488
JOSEPH BUNDY OD
Optometrist
1001 HIGHWAY 15 S
FAIRMONT, MN 56031
Martin County (507) 238-9490
CARLY STEIER
Pharmacist
1001 HIGHWAY 15 S
FAIRMONT, MN 56031
Martin County (507) 238-9488
SHOPKO STORES OPERATING CO LLC
Pharmacy (Community/Retail Pharmacy)
1001 HIGHWAY 15 S
FAIRMONT, MN 56031
Martin County (507) 238-9488

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 1457304024. It was assigned to this organization in the NPPES registry on May 18, 2006. The provider is doing business as Shopko Optical 059.

Where is Shopko Stores Operating Co. LLC located?

Shopko Stores Operating Co. LLC is located at 1001 Highway 15 S, Fairmont, MN 56031. The listed phone number is (507) 238-9490.

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.