Shopko Stores Operating Co. Llc in Dixon - Eyewear Supplier
Shopko Stores Operating Co. Llc - NPI 1700838729
Shopko Stores Operating Co. Llc is a Eyewear Supplier in Dixon, Illinois. Shopko Stores Operating Co. Llc practices all healthcare services and medical treatments related to Eyewear Supplier. The NPI Number for Shopko Stores Operating Co. Llc is 1700838729. The last update date is 2008-06-04.
Shopko Stores Operating Co. Llc's current location address is 1350 N Galena Ave, Dixon, Illinois. You can contact this provider via phone number 8152843935. The mailing address for Shopko Stores Operating Co. Llc is 1350 N Galena Ave, Dixon, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Shopko Stores Operating Co. Llc |
|---|---|
| Address | 1350 N Galena Ave, Dixon, Illinois |
| Phone Number | 8152843935 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | SR. VICE P |
|---|---|
| Authorized Official Name | Bettiga J Michael |
| Credentials | RPH |
| Telephone Number | 9204294297 |
NPI Number Detail
| NPI Number | 1700838729 |
|---|---|
| Provider Enumeration Date | 2006-05-17 |
| Last Updated Date | 2008-06-04 |
Provider Mailing Address Detail
| Address | 1350 N Galena Ave |
|---|---|
| City | Dixon |
| State | Illinois (IL) |
| Post Code | 610211010 |
| Phone Number | 8152843935 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Eyewear Supplier |
|---|---|
| Taxonomy | 332H00000X |
|
Definition: An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 14119 | VIP | ||
| 5232016 | IL | BCBS IL | |
| CP2230-13 | EYEMED | ||
| 17683 | MEDICARE | ||
| 42531 | DAVIS |
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What is the Shopko Stores Operating Co. Llc's 1700838729?
The Shopko Stores Operating Co. Llc's NPI (National Provider Identifier) Number is 1700838729. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
What is the unique identifier code issued to Shopko Stores Operating Co. Llc by the Centers for Medicare & Medicaid Services (CMS)?
The Shopko Stores Operating Co. Llc has been assigned the NPI (National Provider Identifier) 1700838729. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
What is the area of specialization for Shopko Stores Operating Co. Llc, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Shopko Stores Operating Co. Llc is Eyewear Supplier, and the corresponding taxonomy code that categorizes this area of expertise is 332H00000X.
On what date did the Centers for Medicare & Medicaid Services issue the 1700838729 to Shopko Stores Operating Co. Llc?
The Shopko Stores Operating Co. Llc received its 1700838729 assignment from the Centers for Medicare & Medicaid Services on 2006-05-17.
When was the information pertaining to Shopko Stores Operating Co. Llc most recently updated or revised?
The details related to Shopko Stores Operating Co. Llc, including its address, specialty, and other relevant information, were last updated or revised on 2008-06-04.
NPI Number: 1336142389
Address: Po Box 2004, East Syracuse, NY