Shopko Stores Operating Co. LLC
Shopko Stores Operating Co. LLC is a healthcare organization registered as Eyewear Supplier in Logan, UT, holding Type 2 (organization) NPI 1609828136 since 2006. The authorized official on file is Michael Bettiga, Sr. Vice President Health Services.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1609828136 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Shopko Stores Operating Co. LLC |
| Other name | <Unavail> |
| Practice address | 1341 N MAIN ST, Logan, UT, 84341 |
| Phone | 4357530700 |
| Enumeration date | 2006-05-16 |
| Last updated in NPPES | 2008-07-10 |
Authorized official
| Name | Michael Bettiga |
|---|---|
| Title | Sr. Vice President Health Services |
| Phone | 9204294297 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 152W00000X | Optometrist | Secondary | — | — |
| 156FX1800X | Optician | Secondary | — | — |
| 332H00000X | Eyewear Supplier | Primary | — | — |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 35721 | Other | — | AVESIS |
| 014091 | Other | — | VIP |
| 410985054-148 | Medicaid | UT | — |
| CP2230-43 | Other | — | EYEMED |
| 17924 | Other | — | MEDICARE |
| UT04878 | Other | UT | NORIDIAN SUBMITTER ID |
| 42567 | Other | — | DAVIS |
Copy-ready billing details
Provider: Shopko Stores Operating Co. LLC NPI: 1609828136 Taxonomy: 332H00000X (Eyewear Supplier) Address: 1341 N MAIN ST, Logan, UT, 84341
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1679523245 | Alan Hastings | Individual | Optometrist | Logan, UT |
| 1750332730 | Shopko Stores Operating Co LLC | Organization | Community/Retail Pharmacy | Logan, UT |
Verify this record
Cross-check NPI 1609828136 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 2026-07-09. Provider record last updated 2008-07-10.