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SHOPKO OPTICAL 502
NPI 1861445405
Eyewear Supplier in Green Bay, WI

Active since May 17, 2006
2585 LINEVILLE RD, GREEN BAY, WI 54313(920) 662-9450 Get Directions Write a Review

NPPES record last updated: February 11, 2008. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Shopko Optical 502 NPPES

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

SHOPKO OPTICAL 502 (NPI 1861445405) is a healthcare organization registered as an eyewear supplier in Green Bay, 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.Information from the official NPPES registry record.

NPPES Registry Identity

NPI1861445405
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameSHOPKO STORES OPERATING CO. LLC
Location Address2585 LINEVILLE RDGreen Bay, WI 54313-7122
Mailing Address2585 Lineville RdGreen Bay, WI 54313-7122 · (920) 662-9450
Phone(920) 662-9450
Organization SubpartNo
Authorized OfficialMichael J BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateMay 17, 2006
Last NPPES UpdateFebruary 11, 2008
✔ NPI 1861445405 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.

2585 LINEVILLE RD, Green Bay, WI 54313
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Other Names 1

Doing Business AsShopko Optical 502

Other Identifiers 9

Medicaid38723100WI
Other50115Davis
Medicare NSC5695760021WI
Other014502Vip
Other410985054-4502Nva
Other25866Medicare
Medicare PINDF0804
Medicare ID-Type Unspecified0154160300
OtherCP2230-71Eyemed

Reviews for SHOPKO OPTICAL 502

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Other Providers at the Same Location


The following 4 providers are registered at the same or a nearby location.

DR. DAVID CLARK LIEBURN O.D.
Optometrist
2585 LINEVILLE RD
GREEN BAY, WI 54313
Brown County (920) 662-9450
MR. DARRIN D WIRKES R.PH.
Pharmacist
2585 LINEVILLE RD, SHOPKO EXPRESS #502
GREEN BAY, WI 54313
Brown County (920) 662-9450
ORLANDO SIERRALTA
Pharmacist
2585 LINEVILLE RD
GREEN BAY, WI 54313
Brown County (920) 662-9450
SHOPKO STORES OPERATING CO LLC
Pharmacy (Community/Retail Pharmacy)
2585 LINEVILLE RD
GREEN BAY, WI 54313
Brown County (920) 662-9450

Frequently Asked Questions

What is SHOPKO STORES OPERATING CO. LLC's NPI number?

The NPI number assigned to this healthcare provider is 1861445405, enumerated as an "organization" on May 17, 2006.

Where is the provider located?

The provider is located at 2585 LINEVILLE RD GREEN BAY, WI 54313 and the phone number is (920) 662-9450.

What is the provider's specialty?

Eyewear Supplier with taxonomy code 332H00000X.

What insurance does SHOPKO STORES OPERATING CO. LLC accept?

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.