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 1396797411

Shopko Stores Operating Co LLC is an Eyewear Supplier in Beaver Dam, 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

822 Park Ave
Beaver Dam, WI 53916-2266
Phone: (920) 887-3791
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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 number1396797411
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michael Bettiga — Sr. Vice President Health Services · (920) 429-4297
Other names Shopko Optical 014
NPI enumeratedMay 17, 2006
Last updated in NPPESFebruary 11, 2008
Mailing address822 Park Ave, Beaver Dam, WI 53916-2266

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