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
1200 SUSAN DR
MARSHALL, MN56258-2580
Phone: 507-537-9652
Fax:
Website:
Specialty Taxonomy Code
* Eyewear Supplier 332H00000X

* Indicates primary specialty

NPI Profile & details for SHOPKO STORES OPERATING CO. LLC

NPI Number 1801848890
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: 35695 AVESIS
  • Other: 42615 DAVIS
  • Other: CP2230-21 EYEMED
  • Other: 17824 MEDICARE
  • Other: 4C071SH MN BLUE PLUS CARE
  • Other: 3C214SH MN MA FIRST PLAN OF MN
  • Other: 03092036204 MN MA PRIMEWEST HEALTH
  • Other: 014025 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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