institution
Shopko Stores Operating Co. Llc
Eyewear Supplier in Green Bay, Wisconsin
NPI 1861445405

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 1861445405 and holds a License No. (Wisconsin).

The current practice location address for Shopko Stores Operating Co. Llc is 2585 Lineville Rd, Green Bay, WI and can be reached out via phone at 920-662-9450.

Location: 2585 Lineville Rd, Green Bay, WI, 54313-7122
institution
Provider Profile Details
NPI Number
1861445405
Provider Name
Shopko Stores Operating Co. Llc
Credential
Provider Entity Type
Organization
Address
2585 Lineville Rd, Green Bay, WI, 54313-7122
Phone Number
920-662-9450
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
014502 01 VIP
50115 01 DAVIS
25866 01 MEDICARE
410985054-4502 01 NVA
CP2230-71 01 EYEMED
38723100 05 WI
institution
Provider Business Practice Location Address Details
Address
2585 Lineville Rd
City
State
Zip
54313-7122
Phone Number
920-662-9450
Fax Number
person
Provider Business Mailing Address Details
Address
2585 Lineville Rd
City
State
Zip
54313-7122
Phone Number
920-662-9450
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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