SHOPKO OPTICAL 102
NPI 1649222522
Eyewear Supplier in Marinette, WI

Active since May 17, 2006
2741 ROOSEVELT RD, MARINETTE, WI 54143(715) 735-0260 Get Directions Write a Review

NPPES record last updated: February 11, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Shopko Optical 102 NPPES

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

SHOPKO OPTICAL 102 (NPI 1649222522) is a healthcare organization registered as an eyewear supplier in Marinette, Wisconsin 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

NPI1649222522
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameSHOPKO STORES OPERATING CO. LLC
Location Address2741 ROOSEVELT RDMarinette, WI 54143-3833
Mailing Address2741 Roosevelt RdMarinette, WI 54143-3833 · (715) 735-0260
Organization SubpartNo
Authorized OfficialMichael J BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateMay 17, 2006
Last NPPES UpdateFebruary 11, 2008
NPI 1649222522 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.
2741 ROOSEVELT RD, Marinette, WI 54143

Other Names 1

Doing Business AsShopko Optical 102

Other Identifiers 10

Medicare PINDF0804
OtherCP2230-80Eyemed
Medicaid38443800WI
Other014102Vip
Other410985054-4102Nva
Other13862Medicare
Medicare NSC5695760082WI
Other35577Avesis
Other42580Davis
Medicare ID-Type Unspecified0154160127

Other Providers at the Same Location NPPES 12

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

Pharmacist
2741 ROOSEVELT RD
MARINETTE, WI 54143
Nurse Practitioner (Family)
2741 ROOSEVELT RD
MARINETTE, WI 54143
Pharmacist
2741 ROOSEVELT RD
MARINETTE, WI 54143
Physician Assistant
2741 ROOSEVELT RD
MARINETTE, WI 54143
Family Medicine
2741 ROOSEVELT RD
MARINETTE, WI 54143
Nurse Practitioner
2741 ROOSEVELT RD
MARINETTE, WI 54143
Nurse Practitioner (Family)
2741 ROOSEVELT RD
MARINETTE, WI 54143
Pharmacy (Community/Retail Pharmacy)
2741 ROOSEVELT RD
MARINETTE, WI 54143

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 1649222522. It was assigned to this organization in the NPPES registry on May 17, 2006. The provider is doing business as Shopko Optical 102.

Where is Shopko Stores Operating Co. LLC located?

Shopko Stores Operating Co. LLC is located at 2741 Roosevelt Rd, Marinette, WI 54143. The listed phone number is (715) 735-0260.

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 February 11, 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.