Shopko Stores Operating,Co.,Llc

LBN: Shopko Stores Operating,Co.,Llc
Shopko Stores Operating,Co.,Llc is an health care organization with primary practice located at 6218 Trail Ridge Ct , Oregon WI 53575-2534. The organization recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as the primary health care specialty. Shopko Stores Operating,Co.,Llc can be contacted via phone (608) 222-9420, or through Olson, Richard Dewey via phone (608) 222-9420.

Contact Information

Primary practice address
6218 Trail Ridge Ct Oregon WI 53575-2534
Phone: (608) 222-9420
Fax: (608) 222-0578
Website:
Map and Directions
Authorized official contact:
Name: Olson, Richard Dewey Doctor of Optometry (OD)
Phone: (608) 222-9420

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 1772 Wisconsin

Profile Details

NPI number 1265483168
LBN Legal business name Shopko Stores Operating,Co.,Llc
DBA Doing business as
Authorized official Olson, Richard Dewey Doctor of Optometry (OD)
Entity Organization
Organization subpart 1 No
Enumeration date May 15th, 2006
Last updated Aug 22nd, 2020 - about 4 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 1265483168 NPPES
Wisconsin MEDICAID 38416300

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