SHOPKO OPTICAL 058
NPI 1871545996
Eyewear Supplier in Worthington, MN

Active since May 17, 2006
1755 N HUMISTON AVE, WORTHINGTON, MN 56187(507) 372-7811 Get Directions Write a Review

NPPES record last updated: April 15, 2008. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Shopko Optical 058 NPPES

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

SHOPKO OPTICAL 058 (NPI 1871545996) is a healthcare organization registered as an eyewear supplier in Worthington, 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

NPI1871545996
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameSHOPKO STORES OPERATING CO. LLC
Location Address1755 N HUMISTON AVEWorthington, MN 56187-1757
Mailing Address1755 N Humiston AveWorthington, MN 56187-1757 · (507) 372-7811
Organization SubpartNo
Authorized OfficialMichael J BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateMay 17, 2006
Last NPPES UpdateApril 15, 2008
NPI 1871545996 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.
1755 N HUMISTON AVE, Worthington, MN 56187

Other Names 1

Doing Business AsShopko Optical 058

Other Identifiers 12

Other3C194SHMn Blue Plus Care
Other17829Medicare
Other35487Avesis
Other20019120528Mn Ma Primewest Health
Other014058Vip
Other213121-19Eyemed
Medicare ID-Type Unspecified1111590008
Medicare PINDF0849
Other33300Mn Health Partners
Other42492Davis
Medicare PINC04276
Medicare NSC5695760032MN

Other Providers at the Same Location NPPES 5

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

Pharmacy (Community/Retail Pharmacy)
1755 N HUMISTON AVE
WORTHINGTON, MN 56187
Pharmacist
1755 N HUMISTON AVE
WORTHINGTON, MN 56187
Optometrist
1755 N HUMISTON AVE
WORTHINGTON, MN 56187
Pharmacist
1755 N HUMISTON AVE
WORTHINGTON, MN 56187
Pharmacist
1755 N HUMISTON AVE
WORTHINGTON, MN 56187

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 1871545996. It was assigned to this organization in the NPPES registry on May 17, 2006. The provider is doing business as Shopko Optical 058.

Where is Shopko Stores Operating Co. LLC located?

Shopko Stores Operating Co. LLC is located at 1755 N Humiston Ave, Worthington, MN 56187. The listed phone number is (507) 372-7811.

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 with the weekly NPPES data releases published by CMS.