institution
Shopko Stores Operating Co. Llc
Eyewear Supplier in Idaho Falls, Idaho
NPI 1952354540

Shopko Stores Operating Co. Llc is a Eyewear Supplier based in Idaho Falls, ID. Shopko Stores Operating Co. Llc practices in Idaho Falls, ID. The NPI Number for Shopko Stores Operating Co. Llc is 1952354540 and holds a License No. (Idaho).

The current practice location address for Shopko Stores Operating Co. Llc is 800 E 17Th St, Idaho Falls, ID and can be reached out via phone at 208-522-3795.

Location: 800 E 17Th St, Idaho Falls, ID, 83404-6151
institution
Provider Profile Details
NPI Number
1952354540
Provider Name
Shopko Stores Operating Co. Llc
Credential
Provider Entity Type
Organization
Address
800 E 17Th St, Idaho Falls, ID, 83404-6151
Phone Number
208-522-3795
Fax Number
Provider Enumeration Date
05/18/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1379406 01 MEDICARE
17836 01 MEDICARE
213121-5 01 EYEMED
014068 01 VIP
42505 01 DAVIS VISION
806430104 05 ID
000310100 05 ID
institution
Provider Business Practice Location Address Details
Address
800 E 17Th St
City
State
Zip
83404-6151
Phone Number
208-522-3795
Fax Number
person
Provider Business Mailing Address Details
Address
800 E 17Th St
City
State
Zip
83404-6151
Phone Number
208-522-3795
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...
person
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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