National Provider Identifier Database

SHOPKO STORES OPERATING CO LLC
Eyewear Supplier

An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.

Contact Information

SHOPKO STORES OPERATING CO. LLC
2820 HIGHWAY 63 S
ROCHESTER, MN  55904-5571
Phone: 507-281-0687
Fax:
Website:
Specialty Taxonomy Code
* Eyewear Supplier 332H00000X

* Indicates primary specialty

NPI Profile & details for SHOPKO STORES OPERATING CO. LLC

NPI Number 1700838802
Legal business name
LBN		 SHOPKO STORES OPERATING CO. LLC
Authorized official MICHAEL BETTIGA - (SR. VICE PRESIDENT HEALTH SERVICES)
Entity Organization
Organization subpart No
Enumeration date 05/17/2006
Last updated 04/15/2008 - About 18 years ago
Sole proprietor1 Not specified
Identifiers
  • Other: 35471 AVESIS
  • Other: 42617 DAVIS
  • Other: 213121-15 EYEMED
  • Other: 17825 MEDICARE
  • Other: 36055 MN HEALTH PARTNERS
  • Other: 39687SH MN MA FIRST PLAN OF MN
  • Other: 39701SH MN MA FIRST PLAN OF MN
  • Other: 20019120523 MN MA PRIMEWEST HEALTH
  • Other: 014035 VIP

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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