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Shopko Stores Operating Co. LLC

Eyewear Supplier in Grafton, WI · enumerated 2006 · authorized official Michael Bettiga, Sr. Vice President Health Services.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1104879808

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Registry record

Entity type Organization (Type 2)
Legal business name Shopko Stores Operating Co. LLC
Other name <Unavail>
Practice address 1771 Wisconsin Ave, Grafton, WI, 53024
Enumeration date May 17, 2006
Last updated in NPPES Feb 11, 2008

Taxonomy & classification

332H00000X Eyewear Supplier Suppliers Primary

Authorized official

Name Michael Bettiga
Title Sr. Vice President Health Services

Other identifiers

Identifier Type State Issuer
410985054-4090 Other - NVA
42561 Other - DAVIS
38441700 Medicaid WI -
014090 Other - VIP
CP2230-1 Other - EYEMED
13860 Other - MEDICARE

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is a Type 2 NPI?
A Type 2 NPI identifies an organization (group practice, hospital, pharmacy, lab), while Type 1 NPIs identify individual providers. Organizations bill under their Type 2 NPI.
What type of organization is Shopko Stores Operating Co. LLC?
Shopko Stores Operating Co. LLC is registered in NPPES as a Eyewear Supplier (its primary provider taxonomy).

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2008-02-11.