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SHOPKO STORES OPERATING CO. LLC NPI 1700838802


NPI Information

NPI: 1700838802
Provider Name: SHOPKO STORES OPERATING CO. LLC

Doing Business As: SHOPKO OPTICAL 035

Classification: Eyewear Supplier - 332H00000X
Entity Type: Organization
Address:
2820 HIGHWAY 63 S
ROCHESTER, MN
ZIP 55904
Phone: (507) 281-0687
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SHOPKO STORES OPERATING CO. LLC is an eyewear supplier in Rochester, MN. 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 1700838802. The provider is registered as an organization entity type.
The provider Is Doing Business As Shopko Optical 035.

The provider's business location address is:

2820 HIGHWAY 63 S
ROCHESTER, MN
ZIP 55904-571
Phone: (507) 281-0687

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 4/15/2008.


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
142617OTHERDAVIS
235471OTHERAVESIS
339687SHOTHERMN MA FIRST PLAN OF MN
4213121-15OTHEREYEMED
55695760051MEDICARE NSCMINNESOTA
6C04276MEDICARE PIN
736055OTHERMN HEALTH PARTNERS
81111590006MEDICARE ID-TYPE UNSPECIFIED
939701SHOTHERMN MA FIRST PLAN OF MN
10014035OTHERVIP
1120019120523OTHERMN MA PRIMEWEST HEALTH
12DF0849MEDICARE PIN
1317825OTHERMEDICARE

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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