institution
Shopko Stores Operating Co. Llc
Eyewear Supplier in Grafton, Wisconsin
NPI 1104879808

Shopko Stores Operating Co. Llc is a Eyewear Supplier based in Grafton, WI. Shopko Stores Operating Co. Llc practices in Grafton, WI. The NPI Number for Shopko Stores Operating Co. Llc is 1104879808 and holds a License No. (Wisconsin).

The current practice location address for Shopko Stores Operating Co. Llc is 1771 Wisconsin Ave, Grafton, WI and can be reached out via phone at 262-375-0505.

Location: 1771 Wisconsin Ave, Grafton, WI, 53024-2437
institution
Provider Profile Details
NPI Number
1104879808
Provider Name
Shopko Stores Operating Co. Llc
Credential
Provider Entity Type
Organization
Address
1771 Wisconsin Ave, Grafton, WI, 53024-2437
Phone Number
262-375-0505
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
410985054-4090 01 NVA
42561 01 DAVIS
38441700 05 WI
014090 01 VIP
CP2230-1 01 EYEMED
13860 01 MEDICARE
institution
Provider Business Practice Location Address Details
Address
1771 Wisconsin Ave
City
State
Zip
53024-2437
Phone Number
262-375-0505
Fax Number
person
Provider Business Mailing Address Details
Address
1771 Wisconsin Ave
City
State
Zip
53024-2437
Phone Number
262-375-0505
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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