SHOPKO STORES OPERATING CO. LLC NPI 1083667638

NPI Information

SHOPKO STORES OPERATING CO. LLC is an eyewear supplier in Kenosha, 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 1083667638. The provider is registered as an organization entity type.
The provider Is Doing Business As Shopko Optical 031.

The provider's business location address is:

5300 52ND ST
KENOSHA, WI
ZIP 53144-310
Phone: (262) 658-8119

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:

Other Identifiers

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

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.