SHOPKO OPTICAL 065
NPI 1982656096
Eyewear Supplier in Boise, ID

Active since May 17, 2006
8105 FAIRVIEW AVE, BOISE, ID 83704(208) 323-9303 Get Directions Write a Review

NPPES record last updated: August 3, 2009. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Shopko Optical 065 NPPES

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

SHOPKO OPTICAL 065 (NPI 1982656096) is a healthcare organization registered as an eyewear supplier in Boise, Idaho 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

NPI1982656096
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameSHOPKO STORES OPERATING CO. LLC
Location Address8105 FAIRVIEW AVEBoise, ID 83704-8486
Mailing Address8105 Fairview AveBoise, ID 83704-8486 · (208) 323-9303
Organization SubpartNo
Authorized OfficialMichael J BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateMay 17, 2006
Last NPPES UpdateAugust 3, 2009
NPI 1982656096 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyEyewear SupplierSuppliers
Taxonomy Code332H00000X
Definition

An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.

Also ListedTechnician/Technologist · OpticianTaxonomy 156FX1800X
8105 FAIRVIEW AVE, Boise, ID 83704

Other Names 1

Doing Business AsShopko Optical 065

Other Identifiers 13

Medicare PIN1369445ID
Medicare PINDF0850
Other213121-2Eyemed
Other42502-000Davis Vision
Other35441Avesis
Medicaid806430102ID
Other1379401Medicare
Other014065Vip
Medicare ID-Type Unspecified0154160243
Medicare NSC5695760011ID
Other410985054-4065Uwg
Other17834Medicare
Medicaid000310000ID

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

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

Pharmacy (Community/Retail Pharmacy)
8105 FAIRVIEW AVE
BOISE, ID 83704

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 1982656096. It was assigned to this organization in the NPPES registry on May 17, 2006. The provider is doing business as Shopko Optical 065.

Where is Shopko Stores Operating Co. LLC located?

Shopko Stores Operating Co. LLC is located at 8105 Fairview Ave, Boise, ID 83704. The listed phone number is (208) 323-9303.

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 August 3, 2009. NPI Profile syncs with the weekly NPPES data releases published by CMS.