Shopko Stores Operating Co. LLC
Shopko Stores Operating Co. LLC is a healthcare organization registered as Eyewear Supplier in Oshkosh, WI, holding Type 2 (organization) NPI 1235181298 since 2006. The authorized official on file is Michael Bettiga, Sr. Vice President Health Services.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1235181298 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Shopko Stores Operating Co. LLC |
| Other name | <Unavail> |
| Practice address | 1300 S KOELLER ST, Oshkosh, WI, 54902 |
| Phone | 9204265730 |
| Enumeration date | 2006-05-17 |
| Last updated in NPPES | 2008-02-11 |
Authorized official
| Name | Michael Bettiga |
|---|---|
| Title | Sr. Vice President Health Services |
| Phone | 9204294297 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 332H00000X | Eyewear Supplier | Primary | — | — |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CP2230-85 | Other | — | EYEMED |
| 17653 | Other | — | MEDICARE |
| 014042 | Other | — | VIP |
| 35722 | Other | — | AVESIS |
| 38425700 | Medicaid | WI | — |
| 410985054-4042 | Other | — | NVA |
| 42595 | Other | — | DAVIS |
Copy-ready billing details
Provider: Shopko Stores Operating Co. LLC NPI: 1235181298 Taxonomy: 332H00000X (Eyewear Supplier) Address: 1300 S KOELLER ST, Oshkosh, WI, 54902
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1962458315 | Shopko Stores Operating Co LLC | Organization | Community/Retail Pharmacy | Oshkosh, WI |
| 1598105520 | Bruce Rogers | Individual | Pharmacist | Oshkosh, WI |
| 1194152108 | Dana Kleveland | Individual | Pharmacist | Oshkosh, WI |
| 1548691371 | Luke Mittelstaedt | Individual | Pharmacist | Oshkosh, WI |
Verify this record
Cross-check NPI 1235181298 against the authoritative CMS record: view Shopko Stores Operating Co. LLC on the official NPPES registry .
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. Read the full guide or validate an NPI number.
Frequently asked questions
What is a Type 2 NPI?
What type of organization is Shopko Stores Operating Co. LLC?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2008-02-11.