institution
Shopko Stores Operating Co. Llc
Eyewear Supplier in Boise, Idaho
NPI 1477505485

Shopko Stores Operating Co. Llc is a Eyewear Supplier based in Boise, ID. Shopko Stores Operating Co. Llc practices in Boise, ID. The NPI Number for Shopko Stores Operating Co. Llc is 1477505485 and holds a License No. (Idaho).

The current practice location address for Shopko Stores Operating Co. Llc is 2655 Broadway Ave, Boise, ID and can be reached out via phone at 208-345-8812.

Location: 2655 Broadway Ave, Boise, ID, 83706-4721
institution
Provider Profile Details
NPI Number
1477505485
Provider Name
Shopko Stores Operating Co. Llc
Credential
Provider Entity Type
Organization
Address
2655 Broadway Ave, Boise, ID, 83706-4721
Phone Number
208-345-8812
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
42577 01 DAVIS VISION
000309600 05 ID
213121-3 01 EYEMED
17839 01 MEDICARE
410985054-4095 01 UWG
1379405 01 MEDICARE
806430107 05 ID
014095 01 VIP
institution
Provider Business Practice Location Address Details
Address
2655 Broadway Ave
City
State
Zip
83706-4721
Phone Number
208-345-8812
Fax Number
person
Provider Business Mailing Address Details
Address
2655 Broadway Ave
City
State
Zip
83706-4721
Phone Number
208-345-8812
Fax Number
person
Provider's Taxonomy Details 1
Type
Eye and Vision Services Providers
Classification
Technician/Technologist
Speciality
Optician
Taxonomy
License No.
()
Definition
Definition to come...
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Provider's Taxonomy Details 2
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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