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SHOPKO OPTICAL MANUFACTURING LLC
NPI 1821243650
Eyewear Supplier in De Pere, WI

Active since November 20, 2008
1450 W MAIN AVE, DE PERE, WI 54115(920) 429-7253 Get Directions Write a Review

NPPES record last updated: February 24, 2009. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Shopko Optical Manufacturing Llc NPPES

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

SHOPKO OPTICAL MANUFACTURING LLC (NPI 1821243650) is a healthcare organization registered as an eyewear supplier in De Pere, Wisconsin and active in the NPI registry since November 2008. The organization lists Michael Bettiga, Sr. Vice President Health Services, as its authorized official.

NPPES Registry Identity

NPI1821243650
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameSHOPKO OPTICAL MANUFACTURING LLC
Location Address1450 W MAIN AVEDe Pere, WI 54115-9369
Mailing Address1450 W Main AveDe Pere, WI 54115-9369 · (920) 429-7179
Phone(920) 429-7253
Organization SubpartNo
Authorized OfficialMichael BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateNovember 20, 2008
Last NPPES UpdateFebruary 24, 2009
✔ NPI 1821243650 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 ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
1450 W MAIN AVE, De Pere, WI 54115
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Other Identifiers 1

Medicaid38456800WI

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 Optical Manufacturing LLC's NPI number?

The NPI number for Shopko Optical Manufacturing LLC is 1821243650. It was assigned to this organization in the NPPES registry on November 20, 2008.

Where is Shopko Optical Manufacturing LLC located?

Shopko Optical Manufacturing LLC is located at 1450 W Main Ave, De Pere, WI 54115. The listed phone number is (920) 429-7253.

What is Shopko Optical Manufacturing 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 Optical Manufacturing LLC was last updated on February 24, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.