institution
Shopko Stores Operating Co. Llc
Eyewear Supplier in Delavan, Wisconsin
NPI 1922051861

Shopko Stores Operating Co. Llc is a Eyewear Supplier based in Delavan, WI. Shopko Stores Operating Co. Llc practices in Delavan, WI. The NPI Number for Shopko Stores Operating Co. Llc is 1922051861 and holds a License No. (Wisconsin).

The current practice location address for Shopko Stores Operating Co. Llc is 1450 E Geneva St, Delavan, WI and can be reached out via phone at 262-728-0068.

Location: 1450 E Geneva St, Delavan, WI, 53115-2025
institution
Provider Profile Details
NPI Number
1922051861
Provider Name
Shopko Stores Operating Co. Llc
Credential
Provider Entity Type
Organization
Address
1450 E Geneva St, Delavan, WI, 53115-2025
Phone Number
262-728-0068
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
38711100 05 WI
CP2230-64 01 EYEMED
42544 01 DAVIS
014127 01 VIP
410985054Y8 05 WI
17663 01 MEDICARE
institution
Provider Business Practice Location Address Details
Address
1450 E Geneva St
City
State
Zip
53115-2025
Phone Number
262-728-0068
Fax Number
person
Provider Business Mailing Address Details
Address
1450 E Geneva St
City
State
Zip
53115-2025
Phone Number
262-728-0068
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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