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Shopko Stores Operating Co. Llc
Eyewear Supplier in Twin Falls, Idaho
NPI 1821040973

Shopko Stores Operating Co. Llc is a Eyewear Supplier based in Twin Falls, ID. Shopko Stores Operating Co. Llc practices in Twin Falls, ID. The NPI Number for Shopko Stores Operating Co. Llc is 1821040973 and holds a License No. (Idaho).

The current practice location address for Shopko Stores Operating Co. Llc is 1649 Poleline Rd E, Twin Falls, ID and can be reached out via phone at 208-734-3908.

Location: 1649 Poleline Rd E, Twin Falls, ID, 83301-3592
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1821040973
Provider Name
Shopko Stores Operating Co. Llc
Credential
Provider Entity Type
Organization
Address
1649 Poleline Rd E, Twin Falls, ID, 83301-3592
Phone Number
208-734-3908
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
014067 01 VIP
1379402 01 MEDICARE
000309700 05 ID
17835 01 MEDICARE
213121-8 01 EYEMED
806430103 05 ID
institution
Provider Business Practice Location Address Details
Address
1649 Poleline Rd E
City
Twin Falls
State
Idaho
Zip
83301-3592
Phone Number
208-734-3908
Fax Number
person
Provider Business Mailing Address Details
Address
1649 Poleline Rd E
City
Twin Falls
State
Idaho
Zip
83301-3592
Phone Number
208-734-3908
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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