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SHOPKO OPTICAL 011
NPI 1851341390
Eyewear Supplier in Kingsford, MI

Active since May 12, 2006
500 S CARPENTER AVE, KINGSFORD, MI 49802(906) 779-9164 Get Directions Write a Review

NPPES record last updated: February 11, 2008. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Shopko Optical 011 NPPES

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

SHOPKO OPTICAL 011 (NPI 1851341390) is a healthcare organization registered as an eyewear supplier in Kingsford, Michigan 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

NPI1851341390
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameSHOPKO STORES OPERATING CO. LLC
Location Address500 S CARPENTER AVEKingsford, MI 49802-4529
Mailing Address500 S Carpenter AveKingsford, MI 49802-4529 · (906) 779-9164
Phone(906) 779-9164
Organization SubpartNo
Authorized OfficialMichael J BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateMay 12, 2006
Last NPPES UpdateFebruary 11, 2008
✔ NPI 1851341390 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.

500 S CARPENTER AVE, Kingsford, MI 49802
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Other Names 1

Doing Business AsShopko Optical 011

Other Identifiers 12

Other014011Vip
Other17841Medicarecomplete
Medicaid38443600WI
Medicare NSC5695760124MI
Other35464Avesis
Medicare PINDF0754
Other213121-11Eyemed
Other410985054-4011Nva
Medicare ID-Type Unspecified1111590052
Other0P06320Medicare
Other42578Davis
Medicare PIN0P32290

Other Providers at the Same Location NPPES

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)
500 S CARPENTER AVE
KINGSFORD, MI 49802
Dickinson County (906) 774-7907

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 1851341390. It was assigned to this organization in the NPPES registry on May 12, 2006. The provider is doing business as Shopko Optical 011.

Where is Shopko Stores Operating Co. LLC located?

Shopko Stores Operating Co. LLC is located at 500 S Carpenter Ave, Kingsford, MI 49802. The listed phone number is (906) 779-9164.

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 with the weekly NPPES data releases published by CMS.