Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Shopko Stores Operating Co LLC

Organization Eyewear Supplier · NPI 1083667638

Shopko Stores Operating Co LLC is an Eyewear Supplier in Kenosha, Wisconsin. Registered with an NPI since 2006.

In the registry since
2006
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

5300 52nd St
Kenosha, WI 53144-2310
Phone: (262) 658-8119
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Eyewear Supplier (primary) Taxonomy 332H00000X

Record details

NPI number1083667638
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michael Bettiga — Sr. Vice President Health Services · (920) 429-4297
Other names Shopko Optical 031
NPI enumeratedMay 17, 2006
Last updated in NPPESFebruary 11, 2008
Mailing address5300 52nd St, Kenosha, WI 53144-2310

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