Healther Providers Data Logo


Provider Type Icon

SHOPKO STORES OPERATING CO. LLC NPI 1912950619


NPI Information

NPI: 1912950619
Provider Name: SHOPKO STORES OPERATING CO. LLC

Doing Business As: SHOPKO OPTICAL 100

Classification: Eyewear Supplier - 332H00000X
Entity Type: Organization
Address:
699 GREEN BAY RD
NEENAH, WI
ZIP 54956
Phone: (920) 751-0275
Get Directions

SHOPKO STORES OPERATING CO. LLC is an eyewear supplier in Neenah, WI. 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 1912950619. The provider is registered as an organization entity type.
The provider Is Doing Business As Shopko Optical 100.

The provider's business location address is:

699 GREEN BAY RD
NEENAH, WI
ZIP 54956-153
Phone: (920) 751-0275

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 2/11/2008.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332H00000XEyewear 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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10154160145MEDICARE ID-TYPE UNSPECIFIED
238443900MEDICAIDWISCONSIN
35695760110MEDICARE NSCWISCONSIN
4CP2230-83OTHEREYEMED
517659OTHERMEDICARE
6410985054-4100OTHERNVA
742585OTHERDAVIS
8DF0804MEDICARE PIN
9014100OTHERVIP

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: 5/5/2024
Remove or sync iconNPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI
Next NPI »