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SHOPKO OPTICAL 789
NPI 1952642589
Eyewear Supplier in Waupaca, WI

Active since March 06, 2013
825 W FULTON ST, WAUPACA, WI 54981(715) 258-9000(715) 258-4119 Get Directions Write a Review

NPPES record last updated: March 6, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Shopko Optical 789 NPPES

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

SHOPKO OPTICAL 789 (NPI 1952642589) is a healthcare organization registered as an eyewear supplier in Waupaca, Wisconsin and active in the NPI registry since March 2013. The organization lists Michael Bettiga, Executive Vice President And Coo, as its authorized official.

NPPES Registry Identity

NPI1952642589
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameSHOPKO STORES OPERATING CO.,LLC
Location Address825 W FULTON STWaupaca, WI 54981-1471
Mailing Address825 W Fulton StWaupaca, WI 54981-1471 · (715) 258-9000 · Fax (715) 258-4119
Phone(715) 258-9000
Fax(715) 258-4119
Organization SubpartNo
Authorized OfficialMichael BettigaExecutive Vice President And Coo · 92042949297
Enumeration DateMarch 6, 2013
✔ NPI 1952642589 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.
825 W FULTON ST, Waupaca, WI 54981
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Other Names 1

Doing Business AsShopko Optical 789

Other Providers at the Same Location NPPES 6

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)
825 W FULTON ST
WAUPACA, WI 54981
Waupaca County (715) 258-7621
MR. RANDALL LILJEGREN R.PH.
Pharmacist
825 W FULTON ST
WAUPACA, WI 54981
Waupaca County (715) 258-9000
DR. NIKITA GEORGE TONGAS DDS
Dentist (General Practice)
825 W FULTON ST
WAUPACA, WI 54981
Waupaca County (920) 731-7445
JAMES BERT BASZYNSKI RPH
Pharmacist
825 W FULTON ST
WAUPACA, WI 54981
Waupaca County (715) 258-9000
PARTNERSHIP COMMUNITY HEALTH CENTER, INC
Clinic/Center (Federally Qualified Health Center (FQHC))
825 W FULTON ST
WAUPACA, WI 54981
Waupaca County (920) 731-7445
MELISSA A FLEASE RDH
Dental Hygienist
825 W FULTON ST
WAUPACA, WI 54981
Waupaca County (920) 731-7445

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 1952642589. It was assigned to this organization in the NPPES registry on March 6, 2013. The provider is doing business as Shopko Optical 789.

Where is Shopko Stores Operating Co.,llc located?

Shopko Stores Operating Co.,llc is located at 825 W Fulton St, Waupaca, WI 54981. The listed phone number is (715) 258-9000.

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 March 6, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.