institution
Shopko Stores Operating Co. Llc
Eyewear Supplier in Green Bay, Wisconsin
NPI 1649223413

Shopko Stores Operating Co. Llc is a Eyewear Supplier based in Green Bay, WI. Shopko Stores Operating Co. Llc practices in Green Bay, WI. The NPI Number for Shopko Stores Operating Co. Llc is 1649223413 and holds a License No. (Wisconsin).

The current practice location address for Shopko Stores Operating Co. Llc is 2430 E Mason St, Green Bay, WI and can be reached out via phone at 920-468-4642.

Location: 2430 E Mason St, Green Bay, WI, 54302-3759
institution
Provider Profile Details
NPI Number
1649223413
Provider Name
Shopko Stores Operating Co. Llc
Credential
Provider Entity Type
Organization
Address
2430 E Mason St, Green Bay, WI, 54302-3759
Phone Number
920-468-4642
Fax Number
Provider Enumeration Date
05/19/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
17636 01 MEDICARE
38403100 05 WI
014004 01 VIP
410985054-4004 01 NVA
42520 01 DAVIS
institution
Provider Business Practice Location Address Details
Address
2430 E Mason St
City
State
Zip
54302-3759
Phone Number
920-468-4642
Fax Number
person
Provider Business Mailing Address Details
Address
2430 E Mason St
City
State
Zip
54302-3759
Phone Number
920-468-4642
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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