Shopko Stores Operating Co. Llc in Green Bay - Eyewear Supplier
Shopko Stores Operating Co. Llc - NPI 1861445405
Shopko Stores Operating Co. Llc is a Eyewear Supplier in Green Bay, Wisconsin. 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 1861445405. The last update date is 2008-02-11.
Shopko Stores Operating Co. Llc's current location address is 2585 Lineville Rd, Green Bay, Wisconsin. You can contact this provider via phone number 9206629450. The mailing address for Shopko Stores Operating Co. Llc is 2585 Lineville Rd, Green Bay, Wisconsin. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Shopko Stores Operating Co. Llc |
|---|---|
| Address | 2585 Lineville Rd, Green Bay, Wisconsin |
| Phone Number | 9206629450 |
| 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 | 1861445405 |
|---|---|
| Provider Enumeration Date | 2006-05-17 |
| Last Updated Date | 2008-02-11 |
Provider Mailing Address Detail
| Address | 2585 Lineville Rd |
|---|---|
| City | Green Bay |
| State | Wisconsin (WI) |
| Post Code | 543137122 |
| Phone Number | 9206629450 |
| 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 |
|---|---|---|---|
| 14502 | VIP | ||
| 50115 | DAVIS | ||
| 25866 | MEDICARE | ||
| 410985054-4502 | NVA | ||
| CP2230-71 | EYEMED | ||
| 38723100 | WI | -- |
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What is the unique 10-digit identification code assigned to Shopko Stores Operating Co. Llc by the Centers for Medicare & Medicaid Services?
The Shopko Stores Operating Co. Llc has been issued the NPI (National Provider Identifier) 1861445405, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Where is the Shopko Stores Operating Co. Llc located?
The Shopko Stores Operating Co. Llc is located at 2585 Lineville Rd, Green Bay, WI 543137122.
What is Shopko Stores Operating Co. Llc's area of expertise and its corresponding taxonomy classification?
The Shopko Stores Operating Co. Llc's field of specialization is Eyewear Supplier, and it falls under the taxonomy code 332H00000X, which categorizes healthcare providers based on their areas of practice.
On what date did Shopko Stores Operating Co. Llc receive its 1861445405 assignment from the Centers for Medicare & Medicaid Services?
The Shopko Stores Operating Co. Llc was assigned its 1861445405 on 2006-05-17, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the Shopko Stores Operating Co. Llc's details last updated?
The information pertaining to the Shopko Stores Operating Co. Llc, including its address, specialty, and other details, was most recently updated on 2008-02-11.