Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum

Shopko Stores Operating Co. LLC

Eyewear Supplier in Riverdale, UT · 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

1295788065

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Registry record

Entity type Organization (Type 2)

Legal business name Shopko Stores Operating Co. LLC

Other name <Unavail>

Practice address 4060 Riverdale Rd, Riverdale, UT, 84405

Phone (801) 392-4300

Enumeration date May 19, 2006

Last updated in NPPES Jul 10, 2008

Taxonomy & classification

152W00000X Optometrist Eye and Vision Services Providers Secondary

156FX1800X Optician Eye and Vision Services Providers Secondary

332H00000X Eyewear Supplier Suppliers Primary

Authorized official

Name Michael Bettiga

Title Sr. Vice President Health Services

Phone (920) 429-4297

Other identifiers

Identifier	Type	State	Issuer
410985054-408	Medicaid	UT	-
014109	Other	-	VIP
UT04871	Other	UT	NORIDIAN SUBMITTER ID
42510	Other	-	DAVIS
17932	Other	-	MEDICARE
000090125	Other	-	MEDICARE
CP2230-48	Other	-	EYEMED

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

How current is this record?

Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2008-07-10. Verify at npiregistry.cms.hhs.gov.

Where is Shopko Stores Operating Co. LLC located?

The practice location on file with NPPES is in Riverdale, UT.

Providers at this address

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Shopko Stores Operating Co LLC Community/Retail Pharmacy · Riverdale, UT NPI 1952352932

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2008-07-10.