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Contact Information

SHOPKO STORES OPERATING CO LLC
1166 W SUNSET DRIVE
SUITE F100
WAUKESHA, WI53189
 Phone: 920-429-2211
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Eyewear Supplier

332H00000X 87 All Other Suppliers
Indicates primary specialty

NPI Profile & details for SHOPKO STORES OPERATING CO LLC

NPI # 1275017907
LBN Legal business name SHOPKO STORES OPERATING CO LLC
Authorized official DILIP SEDANI - (VP)
Entity Organization
Organization subpart 1 No
Enumeration date 09/19/2018
Last updated 09/19/2018 - About 8 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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