Shopko Stores Operating Co. LLC
Shopko Stores Operating Co. LLC is a healthcare organization registered as Eyewear Supplier in Onalaska, WI, holding Type 2 (organization) NPI 1972556694 since 2006. The authorized official on file is Michael Bettiga, Sr. Vice President Health Services.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1972556694 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Shopko Stores Operating Co. LLC |
| Other name | <Unavail> |
| Practice address | 9366 STATE ROAD 16, Onalaska, WI, 54650 |
| Phone | 6087812010 |
| 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 |
|---|---|---|---|
| CP2230-84 | Other | — | EYEMED |
| 42583 | Other | — | DAVIS |
| 014099 | Other | — | VIP |
| 17658 | Other | — | MEDICARE |
| 410985054-4099 | Other | — | NVA |
| 35581 | Other | — | AVESIS |
| 38442000 | Medicaid | WI | — |
Copy-ready billing details
Provider: Shopko Stores Operating Co. LLC NPI: 1972556694 Taxonomy: 332H00000X (Eyewear Supplier) Address: 9366 STATE ROAD 16, Onalaska, WI, 54650
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1295781656 | Shopko Stores Operating Co LLC | Organization | Community/Retail Pharmacy | Onalaska, WI |
| 1508110693 | Randy Ammerman | Individual | Pharmacist | Onalaska, WI |
| 1568801066 | Steven Mayer | Individual | Pharmacist | Onalaska, WI |
| 1659713691 | Jerome Boortz | Individual | Pharmacist | Onalaska, WI |
Verify this record
Cross-check NPI 1972556694 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.