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Shopko Stores Operating Co. LLC

Eyewear Supplier in Chubbuck, ID · 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

1336191436

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Registry record

Entity type Organization (Type 2)
Legal business name Shopko Stores Operating Co. LLC
Other name <Unavail>
Practice address 4215 Yellowstone Ave, Chubbuck, ID, 83202
Enumeration date May 17, 2006
Last updated in NPPES Aug 3, 2009

Taxonomy & classification

156FX1800X Optician Eye and Vision Services Providers Secondary
332H00000X Eyewear Supplier Suppliers Primary

Authorized official

Name Michael Bettiga
Title Sr. Vice President Health Services

Other identifiers

Identifier Type State Issuer
17712 Other - MEDICARE
CP2230-10 Other - EYEMED
000309500 Medicaid ID -
42499 Other - DAVIS VISION
806430100 Medicaid ID -
014063 Other - VIP
1593901 Other - MEDICARE
805180700 Medicaid ID -

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 2009-08-03.