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

Shopko Stores Operating Co LLC

Organization Optometrist · NPI 1609828136

Shopko Stores Operating Co LLC is an Optometrist in Logan, Utah. Registered with an NPI since 2006.

In the registry since
2006
Specialties on file
3
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

1341 N Main St
Logan, UT 84341-2221
Phone: (435) 753-0700
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Eyewear Supplier (primary) Taxonomy 332H00000X
Optometrist Taxonomy 152W00000X
Optician Taxonomy 156FX1800X

Record details

NPI number1609828136
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michael Bettiga — Sr. Vice President Health Services · (920) 429-4297
Other names Shopko Optical 091
NPI enumeratedMay 16, 2006
Last updated in NPPESJuly 10, 2008
Mailing address1341 N Main St, Logan, UT 84341-2221

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