Shopko Stores Operating Co Llc in Bend - Eyewear Supplier
Shopko Stores Operating Co Llc - NPI 1023069499
Shopko Stores Operating Co Llc is a Eyewear Supplier in Bend, Oregon. 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 1023069499. The last update date is 2008-03-19.
Shopko Stores Operating Co Llc's current location address is 60 Ne Bend River Mall Dr, Bend, Oregon. You can contact this provider via phone number 5413856079. The mailing address for Shopko Stores Operating Co Llc is 60 Ne Bend River Mall Dr, Bend, Oregon. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Shopko Stores Operating Co Llc |
|---|---|
| Address | 60 Ne Bend River Mall Dr, Bend, Oregon |
| Phone Number | 5413856079 |
| 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 | 1023069499 |
|---|---|
| Provider Enumeration Date | 2006-05-12 |
| Last Updated Date | 2008-03-19 |
Provider Mailing Address Detail
| Address | 60 Ne Bend River Mall Dr |
|---|---|
| City | Bend |
| State | Oregon (OR) |
| Post Code | 977017528 |
| Phone Number | 5413856079 |
| 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 |
|---|---|---|---|
| 17679 | MEDICARECOMPLETE | ||
| 35508 | AVESIS | ||
| 22688 | OR | -- | |
| 14093 | VIP | ||
| 112254 | OR MEDICARE-NORIDIAN | ||
| CP2230-33 | EYEMED | ||
| 42573 | DAVIS VISION | ||
| 5251 | OR | -- |
Post Comment/ Review Below
What is the Shopko Stores Operating Co Llc's unique identification number?
The Shopko Stores Operating Co Llc has been assigned the NPI (National Provider Identifier) Number 1023069499 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you kindly provide the complete physical address where Shopko Stores Operating Co Llc's facilities are geographically located?
The facilities of Shopko Stores Operating Co Llc are physically situated at the following location: 60 Ne Bend River Mall Dr, Bend, OR, 977017528.
What is the Shopko Stores Operating Co Llc's specialty and taxonomy code?
The Shopko Stores Operating Co Llc's specialty is Eyewear Supplier, and the corresponding taxonomy code is 332H00000X.
On what date did the Centers for Medicare & Medicaid Services assign the 1023069499 to Shopko Stores Operating Co Llc?
The Centers for Medicare & Medicaid Services assigned the 1023069499 to Shopko Stores Operating Co Llc on 2006-05-12.
When was the information related to Shopko Stores Operating Co Llc most recently updated or refreshed?
The details pertaining to the Shopko Stores Operating Co Llc, including its address, specialty, and other relevant information, were last updated or refreshed on 2008-03-19.