SHOPKO STORES OPERATING CO LLC; NPI #1821343401

Contact Information

SHOPKO STORES OPERATING CO LLC

200 COMMERCE DR
COLUMBUS, WI 53925

Phone: 920-429-7137
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 Number	`1821343401`
LBN Legal business name	SHOPKO STORES OPERATING CO LLC
Authorized official	MICHAEL BETTIGA - (EXECUTIVE VICE PRESIDENT AND COO)
Entity	Organization
Organization subpart ¹	No
Enumeration date	07/19/2012
Last updated	07/27/2012 - About 14 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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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