institution
Shopko Stores Operating Co. Llc
Eyewear Supplier in Lewiston, Idaho
NPI 1003869678

Shopko Stores Operating Co. Llc is a Eyewear Supplier based in Lewiston, ID. Shopko Stores Operating Co. Llc practices in Lewiston, ID. The NPI Number for Shopko Stores Operating Co. Llc is 1003869678 and holds a License No. (Idaho).

The current practice location address for Shopko Stores Operating Co. Llc is 2120 Thain Grade, Lewiston, ID and can be reached out via phone at 208-746-1050. You can also correspond with Shopko Stores Operating Co. Llc through the mailing address at 2120 THAIN GRADE, LEWISTON, ID - 83501-4105 (mailing address contact number: 208-746-1050).

Location: 2120 Thain Grade, Lewiston, ID, 83501-4105
institution
Provider Profile Details
NPI Number
1003869678
Provider Name
Shopko Stores Operating Co. Llc
Credential
Provider Entity Type
Organization
Address
2120 Thain Grade, Lewiston, ID, 83501-4105
Phone Number
208-746-1050
Fax Number
Provider Enumeration Date
05/18/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1379404 01 MEDICARE
000310200 05 ID
014072 01 VIP
17838 01 MEDICARE
213121-6 01 EYEMED
806430106 05 ID
35447 01 AVESIS
institution
Provider Business Practice Location Address Details
Address
2120 Thain Grade
City
State
Zip
83501-4105
Phone Number
208-746-1050
Fax Number
person
Provider Business Mailing Address Details
Address
2120 Thain Grade
City
State
Zip
83501-4105
Phone Number
208-746-1050
Fax Number
person
Provider's Taxonomy Details 1
Type
Eye and Vision Services Providers
Classification
Technician/Technologist
Speciality
Optician
Taxonomy
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Suppliers
Classification
Eyewear Supplier
Speciality
-
Taxonomy
License No.
()
Definition
An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.
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