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Shopko Stores Operating Co. Llc
Eyewear Supplier in Peoria, Illinois
NPI 1073565180

Shopko Stores Operating Co. Llc is a Eyewear Supplier based in Peoria, IL. Shopko Stores Operating Co. Llc practices in Peoria, IL. The NPI Number for Shopko Stores Operating Co. Llc is 1073565180 and holds a License No. (Illinois).

The current practice location address for Shopko Stores Operating Co. Llc is 2323 W Pioneer Pkwy, Peoria, IL and can be reached out via phone at 309-691-4815.

Location: 2323 W Pioneer Pkwy, Peoria, IL, 61615-1833
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1073565180
Provider Name
Shopko Stores Operating Co. Llc
Credential
Provider Entity Type
Organization
Address
2323 W Pioneer Pkwy, Peoria, IL, 61615-1833
Phone Number
309-691-4815
Fax Number
Provider Enumeration Date
05/17/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
17691 01 MEDICARE
35458 01 AVESIS
014174 01 VIP
CP230-16 01 EYEMED
42575 01 DAVIS
institution
Provider Business Practice Location Address Details
Address
2323 W Pioneer Pkwy
City
Peoria
State
Illinois
Zip
61615-1833
Phone Number
309-691-4815
Fax Number
person
Provider Business Mailing Address Details
Address
2323 W Pioneer Pkwy
City
Peoria
State
Illinois
Zip
61615-1833
Phone Number
309-691-4815
Fax Number
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Eyewear Supplier
Speciality
-
Taxonomy
332H00000X
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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