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SHOPKO STORES OPERATING CO. LLC NPI 1063464063


NPI Information

NPI: 1063464063
Provider Name: SHOPKO STORES OPERATING CO. LLC

Doing Business As: SHOPKO OPTICAL 106

Classification: Eyewear Supplier - 332H00000X
Entity Type: Organization
Address:
905 S 24TH ST W
BILLINGS, MT
ZIP 59102
Phone: (406) 652-7297
Get Directions

SHOPKO STORES OPERATING CO. LLC is an eyewear supplier in Billings, MT. The provider is an organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. SHOPKO STORES OPERATING CO. LLC NPI is 1063464063. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Shopko Optical 106.

The provider's business location address is:

905 S 24TH ST W
BILLINGS, MT
ZIP 59102-408
Phone: (406) 652-7297

The provider's authorized official is Michael J Bettiga .
The authorized official title is Sr. Vice President Health Services and has the following contact phone number (920) 429-4297.

The enumeration date for this NPI number is 5/17/2006 and was last updated on 4/24/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1156FX1800XTechnician/TechnologistOpticianNo
2152W00000XOptometristNo
3332H00000XEyewear SupplierYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
117879OTHERMEDICARE
2DG0079MEDICARE PIN
335490OTHERAVESIS
4000085376MEDICARE PINMONTANA
50154160162MEDICARE ID-TYPE UNSPECIFIED
6CP2230-23OTHEREYEMED
7014106OTHERVIP
80551044MEDICAIDMONTANA
95695760125MEDICARE NSCMONTANA
105695760122MEDICARE NSC
11000084251OTHERMEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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