SHOPKO STORES OPERATING CO. LLC; NPI #1558314328

Contact Information

SHOPKO STORES OPERATING CO. LLC

2201 ZEIER RD
MADISON, WI 53704

Phone: 608-246-2161
Fax:
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Eyewear Supplier	332H00000X	87	All Other Suppliers

Indicates primary specialty

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NPI Profile & details for SHOPKO STORES OPERATING CO. LLC

NPI # 1558314328

LBN Legal business name SHOPKO STORES OPERATING CO. LLC

Authorized official DILIP SEDANI - (VP)

Entity Organization

Organization subpart ¹ No

Enumeration date 05/19/2006

Last updated 09/02/2018 - About 8 years ago

Identifiers

WI	Medicaid	38707300
	Other	35574	AVESIS
	Other	42536	DAVIS
	Other	CP2230-78	EYEMED
	Other	000087921	MEDICARE
	Other	17657	MEDICARE
	Other	410985054-4080	NVA
	Other	014080	VIP

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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SHOPKO STORES OPERATING CO. LLC

Contact Information

Specialty

Eyewear Supplier

NPI Profile & details for SHOPKO STORES OPERATING CO. LLC

Reviews for SHOPKO STORES OPERATING CO. LLC