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SHOPKO OPTICAL 069
NPI 1497708085
Eyewear Supplier in Coeur D Alene, ID

Active since May 18, 2006
217 W IRONWOOD DR, COEUR D ALENE, ID 83814(208) 765-8078 Get Directions Write a Review

NPPES record last updated: August 3, 2009. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Shopko Optical 069 NPPES

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

SHOPKO OPTICAL 069 (NPI 1497708085) is a healthcare organization registered as an eyewear supplier in Coeur D Alene, Idaho 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

NPI1497708085
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameSHOPKO STORES OPERATING CO. LLC
Location Address217 W IRONWOOD DRCoeur D Alene, ID 83814-2651
Mailing Address217 W Ironwood DrCoeur D Alene, ID 83814-2651 · (208) 765-8078
Phone(208) 765-8078
Organization SubpartNo
Authorized OfficialMichael J BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateMay 18, 2006
Last NPPES UpdateAugust 3, 2009
✔ NPI 1497708085 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ 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 ListedTechnician/Technologist · OpticianTaxonomy 156FX1800X
217 W IRONWOOD DR, Coeur D Alene, ID 83814
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Other Names 1

Doing Business AsShopko Optical 069

Other Identifiers 12

Medicare ID-Type Unspecified1111590018
Other35444Avesis
Other42507Davis Vision
Other1379403Medicare
Medicare PIN1369445ID
Medicare PINDF0850
Other213121-4Eyemed
Medicaid806430105ID
Medicare NSC5695760099ID
Other014069Vip
Other17837Medicare
Medicaid000309800ID

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 7

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

MARK SCHNEIDER PHARMD
Pharmacist
217 W IRONWOOD DR
COEUR D ALENE, ID 83814
Kootenai County (208) 765-9586
TAVIS JOHN OSLER
Pharmacist
217 W IRONWOOD DR
COEUR D ALENE, ID 83814
Kootenai County (208) 765-9586
MR. LONNIE EARLE MCCURDIE JR. RPH
Pharmacist
217 W IRONWOOD DR
COEUR D ALENE, ID 83814
Kootenai County (208) 765-9586
SHAWNA ELLIOTT
Pharmacist
217 W IRONWOOD DR
COEUR D ALENE, ID 83814
Kootenai County (208) 765-9586
SHOPKO STORES OPERATING CO LLC
Pharmacy (Community/Retail Pharmacy)
217 W IRONWOOD DR
COEUR D ALENE, ID 83814
Kootenai County (208) 765-9586
DR. TYLER JOEL CRESS PHARMD
Pharmacist
217 W IRONWOOD DR
COEUR D ALENE, ID 83814
Kootenai County (208) 765-9586
HALEY VISION CENTER, PLLC
Optometrist
217 W IRONWOOD DR
COEUR D ALENE, ID 83814
Kootenai County (208) 765-8078

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 1497708085. It was assigned to this organization in the NPPES registry on May 18, 2006. The provider is doing business as Shopko Optical 069.

Where is Shopko Stores Operating Co. LLC located?

Shopko Stores Operating Co. LLC is located at 217 W Ironwood Dr, Coeur D Alene, ID 83814. The listed phone number is (208) 765-8078.

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 August 3, 2009. NPI Profile syncs with the weekly NPPES data releases published by CMS.