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SHOPKO OPTICAL 025
NPI 1801848890
Eyewear Supplier in Marshall, MN

Active since May 17, 2006
1200 SUSAN DR, MARSHALL, MN 56258(507) 537-9652 Get Directions Write a Review

NPPES record last updated: April 15, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Shopko Optical 025 NPPES

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

SHOPKO OPTICAL 025 (NPI 1801848890) is a healthcare organization registered as an eyewear supplier in Marshall, 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

NPI1801848890
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameSHOPKO STORES OPERATING CO. LLC
Location Address1200 SUSAN DRMarshall, MN 56258-2580
Mailing Address1200 Susan DrMarshall, MN 56258-2580 · (507) 537-9652
Phone(507) 537-9652
Organization SubpartNo
Authorized OfficialMichael J BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateMay 17, 2006
Last NPPES UpdateApril 15, 2008
✔ NPI 1801848890 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.
1200 SUSAN DR, Marshall, MN 56258
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Other Names 1

Doing Business AsShopko Optical 025

Other Identifiers 12

Other35695Avesis
Other42615Davis
OtherCP2230-21Eyemed
Medicare PINDF0849
Other03092036204Mn Ma Primewest Health
Medicare ID-Type Unspecified0154160165
Other4C071SHMn Blue Plus Care
Medicare NSC5695760092MN
Other014025Vip
Other17824Medicare
Other3C214SHMn 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.

DR. KENNETH H RISTAU O.D.
Optometrist
1200 SUSAN DR
MARSHALL, MN 56258
Lyon County (507) 537-9652
SHOPKO STORES OPERATING CO LLC
Pharmacy (Community/Retail Pharmacy)
1200 SUSAN DR
MARSHALL, MN 56258
Lyon County (507) 537-9650
SANDI BARTZ RPH
Pharmacist
1200 SUSAN DR
MARSHALL, MN 56258
Lyon County (507) 537-9650

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 1801848890. It was assigned to this organization in the NPPES registry on May 17, 2006. The provider is doing business as Shopko Optical 025.

Where is Shopko Stores Operating Co. LLC located?

Shopko Stores Operating Co. LLC is located at 1200 Susan Dr, Marshall, MN 56258. The listed phone number is (507) 537-9652.

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.