Shopko Stores Operating Co. Llc in Boise - Eyewear Supplier
Shopko Stores Operating Co. Llc - NPI 1477505485
Shopko Stores Operating Co. Llc is a Eyewear Supplier in Boise, Idaho. 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 1477505485. The last update date is 2009-08-03.
Shopko Stores Operating Co. Llc's current location address is 2655 Broadway Ave, Boise, Idaho. You can contact this provider via phone number 2083458812. The mailing address for Shopko Stores Operating Co. Llc is 2655 Broadway Ave, Boise, Idaho. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Shopko Stores Operating Co. Llc |
|---|---|
| Address | 2655 Broadway Ave, Boise, Idaho |
| Phone Number | 2083458812 |
| 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 | 1477505485 |
|---|---|
| Provider Enumeration Date | 2006-05-17 |
| Last Updated Date | 2009-08-03 |
Provider Mailing Address Detail
| Address | 2655 Broadway Ave |
|---|---|
| City | Boise |
| State | Idaho (ID) |
| Post Code | 837064721 |
| Phone Number | 2083458812 |
| 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 |
|---|---|---|---|
| 42577 | DAVIS VISION | ||
| 309600 | ID | -- | |
| 213121-3 | EYEMED | ||
| 17839 | MEDICARE | ||
| 410985054-4095 | UWG | ||
| 1379405 | MEDICARE | ||
| 806430107 | ID | -- | |
| 14095 | VIP |
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Shopko Stores Operating Co. Llc by the Centers for Medicare & Medicaid Services?
The Shopko Stores Operating Co. Llc has been assigned the NPI (National Provider Identifier) 1477505485 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Can you provide the Shopko Stores Operating Co. Llc's physical address?
The Shopko Stores Operating Co. Llc is physically located at 2655 Broadway Ave, in the city of Boise, ID, with the postal code 837064721.
What is Shopko Stores Operating Co. Llc's specialized field of practice, and what is the corresponding taxonomy classification code?
The Shopko Stores Operating Co. Llc's area of specialization is Eyewear Supplier, and the corresponding taxonomy code that categorizes this field of practice is 332H00000X.
On what date did the Shopko Stores Operating Co. Llc receive the assignment of its 1477505485 from the Centers for Medicare & Medicaid Services?
The Shopko Stores Operating Co. Llc was issued its 1477505485 by the Centers for Medicare & Medicaid Services on 2006-05-17.
As of what date was the information regarding Shopko Stores Operating Co. Llc, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Shopko Stores Operating Co. Llc, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2009-08-03.