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Shopko Stores Operating Co. Llc
Eyewear Supplier in Chubbuck, Idaho
NPI 1336191436

Shopko Stores Operating Co. Llc is a Eyewear Supplier based in Chubbuck, ID. Shopko Stores Operating Co. Llc practices in Chubbuck, ID. The NPI Number for Shopko Stores Operating Co. Llc is 1336191436 and holds a License No. (Idaho).

The current practice location address for Shopko Stores Operating Co. Llc is 4215 Yellowstone Ave, Chubbuck, ID and can be reached out via phone at 208-237-6822.

Location: 4215 Yellowstone Ave, Chubbuck, ID, 83202-2419
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1336191436
Provider Name
Shopko Stores Operating Co. Llc
Credential
Provider Entity Type
Organization
Address
4215 Yellowstone Ave, Chubbuck, ID, 83202-2419
Phone Number
208-237-6822
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
17712 01 MEDICARE
CP2230-10 01 EYEMED
000309500 05 ID
42499 01 DAVIS VISION
806430100 05 ID
014063 01 VIP
1593901 01 MEDICARE
805180700 05 ID
institution
Provider Business Practice Location Address Details
Address
4215 Yellowstone Ave
City
Chubbuck
State
Idaho
Zip
83202-2419
Phone Number
208-237-6822
Fax Number
person
Provider Business Mailing Address Details
Address
4215 Yellowstone Ave
City
Chubbuck
State
Idaho
Zip
83202-2419
Phone Number
208-237-6822
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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