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SHOPKO OPTICAL 127
NPI 1922051861
Eyewear Supplier in Delavan, WI

Active since May 19, 2006
1450 E GENEVA ST, DELAVAN, WI 53115(262) 728-0068 Get Directions Write a Review

NPPES record last updated: February 11, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Shopko Optical 127 NPPES

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

SHOPKO OPTICAL 127 (NPI 1922051861) is a healthcare organization registered as an eyewear supplier in Delavan, 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.

NPPES Registry Identity

NPI1922051861
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameSHOPKO STORES OPERATING CO. LLC
Location Address1450 E GENEVA STDelavan, WI 53115-2025
Mailing Address1450 E Geneva StDelavan, WI 53115-2025 · (262) 728-0068
Phone(262) 728-0068
Organization SubpartNo
Authorized OfficialMichael J BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateMay 19, 2006
Last NPPES UpdateFebruary 11, 2008
✔ NPI 1922051861 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.
1450 E GENEVA ST, Delavan, WI 53115
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Other Names 1

Doing Business AsShopko Optical 127

Other Identifiers 9

Medicaid38711100WI
Medicare ID-Type Unspecified0154160234
Medicare NSC5695760111WI
Medicare PINDF0804
OtherCP2230-64Eyemed
Other42544Davis
Other014127Vip
Other17663Medicare
Medicaid410985054Y8WI

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.

RICHARD HALL R.PH.
Pharmacist
1450 E GENEVA ST
DELAVAN, WI 53115
Walworth County (262) 728-0062
DR. JAMES WINCHESTER WALLACE O.D.
Optometrist
1450 E GENEVA ST
DELAVAN, WI 53115
Walworth County (262) 728-0068
SHOPKO STORES OPERATING CO LLC
Pharmacy (Community/Retail Pharmacy)
1450 E GENEVA ST
DELAVAN, WI 53115
Walworth County (262) 728-0062
DR. ANNE-MARIE CHRISTINE LASCHEN O.D.
Optometrist
1450 E GENEVA ST
DELAVAN, WI 53115
Walworth County (262) 728-0068
MARK J EGGERICHS R.PH.
Pharmacist
1450 E GENEVA ST
DELAVAN, WI 53115
Walworth County (262) 728-0062

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 1922051861. It was assigned to this organization in the NPPES registry on May 19, 2006. The provider is doing business as Shopko Optical 127.

Where is Shopko Stores Operating Co. LLC located?

Shopko Stores Operating Co. LLC is located at 1450 E Geneva St, Delavan, WI 53115. The listed phone number is (262) 728-0068.

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 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.