Shopko Stores Operating Co. LLC

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

Legal business name

SHOPKO STORES OPERATING CO. LLC

Doing business as

ShopKo Optical 129

Practice address

4515 S Regal St
Spokane, WA 99223-7938

Phone

(509) 448-9686

NPI assigned

May 17, 2006

Last updated

Jun 5, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Michael J Bettiga, RPH

Title

Sr. Vice President Health Services

Phone

(920) 429-4297

Specialties & licenses 3

Addresses

Other names 1

• ShopKo Optical 129 Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244160000000",
    "number": "1023060050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4515 S REGAL ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992237938",
            "telephone_number": "509-448-9686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4515 S REGAL ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992237938",
            "telephone_number": "509-448-9686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHOPKO STORES OPERATING CO. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2009-06-05",
        "status": "A",
        "authorized_official_last_name": "BETTIGA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SR. VICE PRESIDENT HEALTH SERVICES",
        "authorized_official_telephone_number": "920-429-4297",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "156FX1800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ShopKo Optical 129",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Elizabeth Witt Shoop, MS, LMHC
• Shope Psychology PLLC
• Megan Shope, PHD
• Shopko Stores Operating Co LLC (ShopKo Pharmacy 066)
• Shopko Stores Operating Co LLC (ShopKo Pharmacy 129)
• Shopko Stores Operating Co. LLC (ShopKo Optical 066)
• Shoptikal LLC (Shopko Optical 4066)
• Shoquist DMD PLLC (Spokane Dental)
• Misty D Shores, AU.D.
• Christopher Michael Shors

• Eyewear Supplier in Spokane, WA
• Providers in Spokane, WA by specialty
• Eyewear Supplier in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.