Shopko Optical 061

LBN: Shopko Stores Operating Co. Llc
Shopko Optical 061 is an health care organization with primary practice located at 501 Highway 10 Se , Saint Cloud MN 56304-1250. The organization recently has only one registered license in Suppliers / Eyewear Supplier (Equipment, not the service), which is considered as the primary health care specialty. Shopko Stores Operating Co. Llc can be contacted via phone (320) 253-4695, or through Bettiga, Michael J via phone (920) 429-4297.

Contact Information

Primary practice address
501 Highway 10 Se Saint Cloud MN 56304-1250
Phone: (320) 253-4695
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Bettiga, Michael J RPH
Phone: (920) 429-4297

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Eyewear Supplier (Equipment, not the service) 332H00000X

Profile Details

NPI number 1063465789
LBN Legal business name Shopko Stores Operating Co. Llc
DBA Doing business as Shopko Optical 061
Authorized official Bettiga, Michael J RPH
Entity Organization
Organization subpart 1 No
Enumeration date May 17th, 2006
Last updated Apr 15th, 2008 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063465789 NPPES
Other 213121-17 EYEMED
Other 21527 EYEMED
Other 410985054-4061 EYEMED
Other 42497 EYEMED
Other 20019120524 EYEMED
Other 014061 EYEMED
Other 17832 EYEMED
Other 55306HA EYEMED
Other 2100301 EYEMED
Other 26887SH EYEMED
Other 35480 EYEMED

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