Shopko Stores Operating Co. LLC

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

Legal business name

SHOPKO STORES OPERATING CO. LLC

Doing business as

ShopKo Optical 023

Practice address

125 Main St N
Hutchinson, MN 55350-1807

Phone

(320) 587-4945

NPI assigned

May 17, 2006

Last updated

Apr 15, 2008By 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 1

Addresses

Other names 1

• ShopKo Optical 023 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": "1208217600000",
    "number": "1982656906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 MAIN ST N",
            "city": "HUTCHINSON",
            "state": "MN",
            "postal_code": "553501807",
            "telephone_number": "320-587-4945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 MAIN ST N",
            "city": "HUTCHINSON",
            "state": "MN",
            "postal_code": "553501807",
            "telephone_number": "320-587-4945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHOPKO STORES OPERATING CO. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2008-04-15",
        "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": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ShopKo Optical 023",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Andrea M Schuth, PA-C
• Stacie Scrivner, CCC-SLP
• Jane Marie Sears, RN, MA, CNS
• Courtney K Sedgwick, LICSW, LCSW
• Shopko Stores Operating Co LLC (ShopKo Pharmacy 023)
• Shoptikal LLC (Shopko Optical 4276)
• Sara L. Shorter, M.D.
• Karisa Showalter
• Rakshya Shrestha, D.M.D
• Brenda Simon, DO

• Eyewear Supplier in Hutchinson, MN
• Providers in Hutchinson, MN by specialty
• Eyewear Supplier in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2008; 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.