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 1174575500

Shopko Stores Operating Co LLC is an Eyewear Supplier in Saint Cloud, Minnesota. 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

4161 2nd St S
Saint Cloud, MN 56301-3761
Phone: (320) 253-5994
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Eyewear Supplier (primary) Taxonomy 332H00000X

Record details

NPI number1174575500
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michael Bettiga — Sr. Vice President Health Services · (920) 429-4297
Other names Shopko Optical 4017
NPI enumeratedMay 16, 2006
Last updated in NPPESApril 15, 2008
Mailing address4161 2nd St S, Saint Cloud, MN 56301-3761

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