Shopko Optical 130
LBN: Shopko Stores Operating Co. Llc
Shopko Optical 130 is an health care organization with primary practice located at 1777 Paulson Rd , River Falls WI 54022-8299. 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 (715) 425-6144, or through Bettiga, Michael J via phone (920) 429-4297.
Contact Information
Primary practice address
1777 Paulson Rd
River Falls WI 54022-8299
Phone: (715) 425-6144
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Eyewear Supplier (Equipment, not the service) | 332H00000X |
Profile Details
| NPI number | 1508819137 |
|---|---|
| LBN Legal business name | Shopko Stores Operating Co. Llc |
| DBA Doing business as | Shopko Optical 130 |
| Authorized official | Bettiga, Michael J RPH |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | May 17th, 2006 |
| Last updated | Feb 11th, 2008 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1508819137 | NPPES |
| Other | 000087130 | MEDICARE | |
| MEDICAID | 32682 | MEDICARE | |
| Other | 410985054-4130 | MEDICARE | |
| Other | CP2230-88 | MEDICARE | |
| MEDICAID | 2100691 | MEDICARE | |
| MEDICAID | 4C079SH | MEDICARE | |
| Other | 014130 | MEDICARE | |
| MEDICAID | 38449800 | MEDICARE | |
| Other | 42550 | MEDICARE | |
| MEDICAID | 4C080SH | MEDICARE | |
| Other | 17664 | MEDICARE |
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