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Shopko Stores Operating Co. Llc
Eyewear Supplier in Meridian, Idaho
NPI 1184677759

Shopko Stores Operating Co. Llc is a Eyewear Supplier based in Meridian, ID. Shopko Stores Operating Co. Llc practices in Meridian, ID. The NPI Number for Shopko Stores Operating Co. Llc is 1184677759 and holds a License No. (Idaho).

The current practice location address for Shopko Stores Operating Co. Llc is 3499 E Fairview Ave, Meridian, ID and can be reached out via phone at 208-884-1362.

Location: 3499 E Fairview Ave, Meridian, ID, 83642-5848
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1184677759
Provider Name
Shopko Stores Operating Co. Llc
Credential
Provider Entity Type
Organization
Address
3499 E Fairview Ave, Meridian, ID, 83642-5848
Phone Number
208-884-1362
Fax Number
Provider Enumeration Date
05/18/2006
Last Update Date
02/15/2025
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Provider's Legacy Identifiers
Identifier Type State Issuer
CP2230-11 01 EYEMED
014169 01 VIP
1593902 01 MEDICARE
17840 01 MEDICARE
805542700 05 ID
35448 01 AVESIS
806430108 05 ID
42568 01 DAVIS VISION
institution
Provider Business Practice Location Address Details
Address
3499 E Fairview Ave
City
Meridian
State
Idaho
Zip
83642-5848
Phone Number
208-884-1362
Fax Number
person
Provider Business Mailing Address Details
Address
3499 E Fairview Ave
City
Meridian
State
Idaho
Zip
83642-5848
Phone Number
208-884-1362
Fax Number
person
Provider's Taxonomy Details 1
Type
Eye and Vision Services Providers
Classification
Technician/Technologist
Speciality
Optician
Taxonomy
156FX1800X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
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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