SHOPKO STORES OPERATING CO. LLC (NPI# 1124071568) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124071568 |
| Entity Type | Organization |
| Organization Name | SHOPKO STORES OPERATING CO. LLC |
| Other Organization Name | SHOPKO OPTICAL 049 |
| Practice Address |
500 N Hwy 281 Aberdeen SD 57401-1821 |
| Practice Telephone | 6052257677 |
| Mailing Telephone | 6052257677 |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2008-02-11 |
| Authorized Official Name | MICHAEL J BETTIGA (SR. VICE PRESIDENT HEALTH SERVICES) |
| Authorized Official Telephone | 9204294297 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332H00000X | Eyewear Supplier (Equipment, not the service) | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AVESIS | 35516 | 01 | |
| MEDICARE | 17911 | 01 | |
| VIP | 014049 | 01 | |
| EYEMED | 213121-26 | 01 |
| Other Name | Type Code |
|---|---|
| ShopKo Optical 049 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952356644 | Shopko Stores Operating Co. LLC | Eyewear Supplier (Equipment, not the service) | 700 Pilgrim Way, Green Bay, WI 54304-5263 | 2006-05-23 |
| 1760435333 | Shopko Stores Operating Co. LLC | Eyewear Supplier (Equipment, not the service) | 3030 Wabash Ave, Springfield, IL 62704-6413 | 2006-05-18 |
| 1679526263 | Shopko Stores Operating Co. LLC | Eyewear Supplier (Equipment, not the service) | 1640 Appleton Rd, Menasha, WI 54952-1106 | 2006-05-18 |
| 1003869678 | Shopko Stores Operating Co. LLC | Technician/Technologist | 2120 Thain Grade, Lewiston, ID 83501-4105 | 2006-05-18 |
| 1457304024 | Shopko Stores Operating Co. LLC | Eyewear Supplier (Equipment, not the service) | 1001 Highway 15 S, Fairmont, MN 56031-4456 | 2006-05-18 |
| 1497708085 | Shopko Stores Operating Co. LLC | Technician/Technologist | 217 W Ironwood Dr, Coeur D Alene, ID 83814-2651 | 2006-05-18 |
| 1902859515 | Shopko Stores Operating Co. LLC | Technician/Technologist | 301 Northwest Byp, Great Falls, MT 59404-4125 | 2006-05-18 |
| 1750334348 | Shopko Stores Operating Co. LLC | Technician/Technologist | 3101 N Montana Ave, Helena, MT 59602-7813 | 2006-05-18 |
| 1083667638 | Shopko Stores Operating Co. LLC | Eyewear Supplier (Equipment, not the service) | 5300 52nd St, Kenosha, WI 53144-2310 | 2006-05-17 |
| 1396797411 | Shopko Stores Operating Co. LLC | Eyewear Supplier (Equipment, not the service) | 822 Park Ave, Beaver Dam, WI 53916-2266 | 2006-05-17 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | SHOPKO STORES OPERATING CO., LLC | 700 Pilgrim Way, Green Bay, WI 54304 |
| Colorado Business Entities | ShopKo Stores Operating Co., LLC | 700 Pilgrim Way, Green Bay, WI 54304 |
| Iowa Business Entities | SHOPKO STORES OPERATING CO., LLC | 700 Pilgrim Way, Green Bay, WI 54304 |
| Washington State Corporations | SHOPKO STORES OPERATING CO., LLC | 700 Pilgrim Way, Green Bay, WI 54304-5263 |
| Street Address |
500 N HWY 281 |
| City | ABERDEEN |
| State | SD |
| Zip Code | 57401-1821 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619918216 | Jason Arthur Lorenz | Optometrist | 500 N Hwy 281, Aberdeen, SD 57401-1821 | 2006-06-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679002950 | Brenda Lee Pence | Registered Nurse | 305 S. State St., Aberdeen, SD 57401 | 2017-06-08 |
| 1104366475 | Jordan Shangreaux | Specialist/Technologist | 2200 S Roosevelt St, Aberdeen, SD 57401 | 2017-03-06 |
| 1205387545 | Midwest Medical Transport Company, LLC-aberdeen, Sd | Ambulance | 2919 Industrial Avenue, Aberdeen, SD 57401 | 2016-10-21 |
| 1356752471 | Cameron Eichler Enterprises | Hearing Aid Equipment | 110 6th Ave Se Ste 106, Aberdeen, SD 57401 | 2014-05-12 |
| 1184059412 | Richard Allen Ward IIi | Hearing Instrument Specialist | 1315 6th Avenue Se, Suite 4, Aberdeen, SD 57401 | 2013-09-05 |
| 1427395540 | Matthew William Svensen | Physical Therapist | 1109 S Jay St, Aberdeen, SD 57401 | 2013-01-09 |
| 1750655940 | Robert Ashly Froke | Audiologist | 121 4th Ave Sw-suite 1, Natural Hearing Center, Aberdeen, SD 57401 | 2012-03-06 |
| 1457504862 | Rodney S Johnson | Counselor | 14 S Main St Ste 1e, Aberdeen, SD 57401 | 2008-10-29 |
| 1518115005 | Dakota Chiropractic of Aberdeen, PC | Chiropractor | 520 Moccasin Drive, Aberdeen, SD 57401 | 2008-09-09 |
| 1558554626 | Tiffany Zimmerman Hoeft | Speech-Language Pathologist | 39515 Pintail Ave, Aberdeen, SD 57401 | 2007-08-22 |
| Find all providers in zip 57401 | ||||
| Taxonomy Code | 332H00000X |
| Grouping | Suppliers |
| Classification | Eyewear Supplier (Equipment, not the service) |
| An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588220958 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 3307 7th Ave Se Ste 105, Aberdeen, SD 57401-6613 | 2019-05-11 |
| 1144379330 | Cole Vision Corporation | Eyewear Supplier (Equipment, not the service) | 1219 S Boone St, South Shore Mall, Aberdeen, WA 98520-6738 | 2007-01-09 |
| 1477591840 | National Vision, Inc. | Eyewear Supplier (Equipment, not the service) | 909 E Wishkah St, Aberdeen, WA 98520-2901 | 2006-06-04 |
| 1427005917 | National Vision, Inc. | Eyewear Supplier (Equipment, not the service) | 250 Turner St, Aberdeen, NC 28315-2363 | 2006-05-28 |
| 1760664841 | Twin Harbors Eye Center Ps | Eyewear Supplier (Equipment, not the service) | 207 S Chehalis St, Aberdeen, WA 98520-2945 | 2007-11-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457989006 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 3330 E 10th St, Sioux Falls, SD 57103-2107 | 2020-03-30 |
| 1013573484 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1519 9th Ave Se Ste A, Watertown, SD 57201-3960 | 2019-05-11 |
| 1780082628 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 3501 W 41st St Ste A, Sioux Falls, SD 57106-0799 | 2014-12-09 |
| 1215292560 | Eagle Vision | Eyewear Supplier (Equipment, not the service) | 906 1/2 9th Ave Se, Watertown, SD 57201 | 2012-07-11 |
| 1346508348 | Sunland Optical Co., Inc. | Eyewear Supplier (Equipment, not the service) | 2725 Lemay Blvd, Ellsworth Afb, SD 57706-4868 | 2012-04-26 |
| 1679850291 | Visionworks, Inc. | Eyewear Supplier (Equipment, not the service) | 850 W Empire Mall, Sioux Falls, SD 57106-6512 | 2011-11-10 |
| 1881911964 | Cole Vision Corporation | Eyewear Supplier (Equipment, not the service) | 3400 Empire Mall, Sioux Falls, SD 57106-0720 | 2010-04-28 |
| 1306016407 | Lg Optical Enterprises | Eyewear Supplier (Equipment, not the service) | 952 22nd Ave S, Brookings, SD 57006-2830 | 2008-03-04 |
| 1427249721 | Essilor Laboratories of America, Inc | Eyewear Supplier (Equipment, not the service) | 109 New York St, Rapid City, SD 57701-1154 | 2007-08-05 |
| 1518158815 | Essilor Laboratories of America, Inc | Eyewear Supplier (Equipment, not the service) | 3109 W 41st St Ste 115, Sioux Falls, SD 57105-8142 | 2007-08-05 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.