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SHOPKO STORES OPERATING CO. LLC NPI 1750334348


NPI Information

NPI: 1750334348
Provider Name: SHOPKO STORES OPERATING CO. LLC

Doing Business As: SHOPKO OPTICAL 112

Classification: Eyewear Supplier - 332H00000X
Entity Type: Organization
Address:
3101 N MONTANA AVE
HELENA, MT
ZIP 59602
Phone: (406) 443-8860
Get Directions

SHOPKO STORES OPERATING CO. LLC is an eyewear supplier in Helena, MT. 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 1750334348. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Shopko Optical 112.

The provider's business location address is:

3101 N MONTANA AVE
HELENA, MT
ZIP 59602-813
Phone: (406) 443-8860

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 5/18/2006 and was last updated on 4/24/2008.


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
1156FX1800XTechnician/TechnologistOpticianNo
2152W00000XOptometristNo
3332H00000XEyewear 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
10551096MEDICAIDMONTANA
2014112OTHERVIP
317880OTHERMEDICARE
4CP2230-24OTHEREYEMED
5000084250OTHERMEDICARE
60154160205MEDICARE ID-TYPE UNSPECIFIED
7DG0079MEDICARE PIN
85695760123MEDICARE NSCMONTANA
9000085376MEDICARE PINMONTANA

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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