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SHOPKO OPTICAL 041
NPI 1558314104
Eyewear Supplier in Austin, MN

Active since May 17, 2006
1209 18TH AVE NW, AUSTIN, MN 55912(507) 437-8228 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 041 NPPES

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

SHOPKO OPTICAL 041 (NPI 1558314104) is a healthcare organization registered as an eyewear supplier in Austin, 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

NPI1558314104
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameSHOPKO STORES OPERATING CO. LLC
Location Address1209 18TH AVE NWAustin, MN 55912-1881
Mailing Address1209 18th Ave NwAustin, MN 55912-1881 · (507) 437-8228
Phone(507) 437-8228
Organization SubpartNo
Authorized OfficialMichael J BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateMay 17, 2006
Last NPPES UpdateApril 15, 2008
✔ NPI 1558314104 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.
1209 18TH AVE NW, Austin, MN 55912
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Other Names 1

Doing Business AsShopko Optical 041

Other Identifiers 13

Other213121-13Eyemed
Other32500SHMn Blue Plus Care
Medicare NSC5695760050MN
Medicare PINDF0849
Other35554Avesis
Medicare ID-Type Unspecified1111590005
Other20019120526Mn Ma Primewest Health
Other17827Medicare
Other36057Mn Health Partners
Other42593Davis
Other014041Vip
Other32437SHMn Ma First Plan Of Mn
Medicare PINC04276

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.

SHOPKO STORES OPERATING CO LLC
Pharmacy (Community/Retail Pharmacy)
1209 18TH AVE NW
AUSTIN, MN 55912
Mower County (507) 437-7616
DOREEN ANN REED RPH.
Pharmacist
1209 18TH AVE NW
AUSTIN, MN 55912
Mower County (507) 437-7616
MR. RODNEY L. MIDDLEBROOK O.D.
Optometrist
1209 18TH AVE NW
AUSTIN, MN 55912
Mower County (507) 437-8228

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 1558314104. It was assigned to this organization in the NPPES registry on May 17, 2006. The provider is doing business as Shopko Optical 041.

Where is Shopko Stores Operating Co. LLC located?

Shopko Stores Operating Co. LLC is located at 1209 18th Ave NW, Austin, MN 55912. The listed phone number is (507) 437-8228.

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.