Healther Providers Data Logo


Provider Type Icon

SHOPKO STORES OPERATING CO. LLC NPI 1225088768


NPI Information

NPI: 1225088768
Provider Name: SHOPKO STORES OPERATING CO. LLC

Doing Business As: SHOPKO OPTICAL 010

Classification: Eyewear Supplier - 332H00000X
Entity Type: Organization
Address:
1150 W WASHINGTON ST
MARQUETTE, MI
ZIP 49855
Phone: (906) 228-4120
Get Directions

SHOPKO STORES OPERATING CO. LLC is an eyewear supplier in Marquette, MI. 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 1225088768. The provider is registered as an organization entity type.
The provider Is Doing Business As Shopko Optical 010.

The provider's business location address is:

1150 W WASHINGTON ST
MARQUETTE, MI
ZIP 49855-040
Phone: (906) 228-4120

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 5/12/2006 and was last updated on 5/29/2008.


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
10N84900OTHERBCBS IL
29000E210890OTHERMICHIGANBCBS PIN
31111590051MEDICARE ID-TYPE UNSPECIFIED
4410985054-4010OTHERNVA
5213121-12OTHEREYEMED
6014010OTHERVIP
735465OTHERAVESIS
8DF0754MEDICARE PIN
90P32290MEDICARE PIN
1016749OTHERMEDICARECOMPLETE
115695760077MEDICARE NSCMICHIGAN
1242572OTHERDAVIS VISION

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 »