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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.

Location: 5300 52Nd St, Kenosha, WI, 53144-2310
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
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
Kenosha
State
Wisconsin
Zip
53144-2310
Phone Number
262-658-8119
Fax Number
person
Provider Business Mailing Address Details
Address
5300 52Nd St
City
Kenosha
State
Wisconsin
Zip
53144-2310
Phone Number
262-658-8119
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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