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SHOPKO STORES OPERATING CO. LLC NPI 1558313783


NPI Information

NPI: 1558313783
Provider Name: SHOPKO STORES OPERATING CO. LLC

Doing Business As: SHOPKO OPTICAL 045

Classification: Eyewear Supplier - 332H00000X
Entity Type: Organization
Address:
601 GALVIN RD S
BELLEVUE, NE
ZIP 68005
Phone: (402) 293-1840
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SHOPKO STORES OPERATING CO. LLC is an eyewear supplier in Bellevue, NE. 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 1558313783. The provider is registered as an organization entity type.
The provider Is Doing Business As Shopko Optical 045.

The provider's business location address is:

601 GALVIN RD S
BELLEVUE, NE
ZIP 68005-249
Phone: (402) 293-1840

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 5/16/2006 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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1014045OTHERVIP
217885OTHERMEDICARE
335495OTHERAVESIS
410025073800MEDICAIDNEBRASKA
5003340OTHERBLOCK
65695760117MEDICARE NSCNEBRASKA
7099830MEDICARE PINNEBRASKA
8DF0848MEDICARE PIN
935861OTHERDAVIS
10213121-22OTHEREYEMED
111111590010MEDICARE ID-TYPE UNSPECIFIED

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: 4/28/2024

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