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SHOPKO STORES OPERATING CO. LLC NPI 1649222878


NPI Information

NPI: 1649222878
Provider Name: SHOPKO STORES OPERATING CO. LLC
Classification: Eyewear Supplier - 332H00000X
Entity Type: Organization
Address:
3044 S 84TH ST STE 1
OMAHA, NE
ZIP 68124
Phone: (402) 391-1143
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SHOPKO STORES OPERATING CO. LLC is an eyewear supplier in Omaha, 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 1649222878. The provider is registered as an organization entity type.

The provider's business location address is:

3044 S 84TH ST STE 1
OMAHA, NE
ZIP 68124-208
Phone: (402) 391-1143

The provider's authorized official is Russell Steinhorst .
The authorized official title is Svp Chief Financial Officer and has the following contact phone number (920) 429-7489.

The enumeration date for this NPI number is 5/16/2006 and was last updated on 10/10/2017.


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
135860OTHERDAVIS
2260474OTHERMEDICARE
3CP2230-31OTHEREYEMED
40154160225MEDICARE ID-TYPE UNSPECIFIED
5099830MEDICARE PINNEBRASKA
6014044OTHERVIP
741098505418MEDICAIDNEBRASKA
85695760087MEDICARE NSCNEBRASKA
9007124OTHERBLOCK
1035504OTHERAVESIS
1117884OTHERMEDICARE
12DF0848MEDICARE PIN

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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