institution
Shopko Stores Operating Co. Llc
Eyewear Supplier in Kenosha, Wisconsin
NPI 1083667638

Shopko Stores Operating Co. Llc is a Eyewear Supplier based in Kenosha, WI. Shopko Stores Operating Co. Llc practices in Kenosha, WI. The NPI Number for Shopko Stores Operating Co. Llc is 1083667638 and holds a License No. (Wisconsin).

The current practice location address for Shopko Stores Operating Co. Llc is 5300 52Nd St, Kenosha, WI and can be reached out via phone at 262-658-8119. You can also correspond with Shopko Stores Operating Co. Llc through the mailing address at 5300 52ND ST, KENOSHA, WI - 53144-2310 (mailing address contact number: 262-658-8119).

Location: 5300 52Nd St, Kenosha, WI, 53144-2310
institution
Provider Profile Details
NPI Number
1083667638
Provider Name
Shopko Stores Operating Co. Llc
Credential
Provider Entity Type
Organization
Address
5300 52Nd St, Kenosha, WI, 53144-2310
Phone Number
262-658-8119
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
17649 01 MEDICARE
42611 01 DAVIS
CP2230-73 01 EYEMED
014031 01 VIP
38413700 05 WI
410985054-4031 01 NVA
institution
Provider Business Practice Location Address Details
Address
5300 52Nd St
City
State
Zip
53144-2310
Phone Number
262-658-8119
Fax Number
person
Provider Business Mailing Address Details
Address
5300 52Nd St
City
State
Zip
53144-2310
Phone Number
262-658-8119
Fax Number
person
Provider's Taxonomy Details 1
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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