SHOPKO STORES OPERATING CO LLC (NPI# 1275017907) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275017907 |
| Entity Type | Organization |
| Organization Name | SHOPKO STORES OPERATING CO LLC |
| Practice Address |
1166 W Sunset Drive Suite F100 Waukesha WI 53189 |
| Mailing Address |
700 Pilgrim Way Green Bay WI 54304-5263 |
| Practice Telephone | 9204292211 |
| Enumeration Date | 2018-09-19 |
| Last Update Date | 2018-09-19 |
| Authorized Official Name | DILIP SEDANI (VP) |
| Authorized Official Telephone | 9204297688 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332H00000X | Eyewear Supplier (Equipment, not the service) | Suppliers |
| Other Name | Type Code |
|---|---|
| Shopko Eyecare Center 4217 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871076968 | Shopko Stores Operating Co LLC | Eyewear Supplier (Equipment, not the service) | 1810 Jackson St, Oshkosh, WI 54901-2204 | 2018-09-13 |
| 1427547082 | Shopko Stores Operating Co LLC | Eyewear Supplier (Equipment, not the service) | 10996 N Port Washington Rd, Mequon, WI 53092 | 2018-05-08 |
| 1912454505 | Shopko Stores Operating Co LLC | Durable Medical Equipment & Medical Supplies | 908 Nw 6th St, Tulia, TX 79088 | 2016-09-01 |
| 1821545419 | Shopko Stores Operating Co LLC | Durable Medical Equipment & Medical Supplies | 67 Selkirk Way, Oldtown, ID 83822 | 2016-09-01 |
| 1740736586 | Shopko Stores Operating Co LLC | Durable Medical Equipment & Medical Supplies | 94 North 400 East, Delta, UT 84624 | 2016-08-31 |
| 1639625064 | Shopko Stores Operating Co LLC | Pharmacy | 1001 N Center Ave, Hardin, MT 59034-1101 | 2016-08-26 |
| 1649726076 | Shopko Stores Operating Co LLC | Durable Medical Equipment & Medical Supplies | 1635 E Highway 40, Ballard, UT 84066-5217 | 2016-08-26 |
| 1841745155 | Shopko Stores Operating Co LLC | Durable Medical Equipment & Medical Supplies | 301 E Us Highway 20, Gordon, NE 69343-1650 | 2016-08-17 |
| 1821441205 | Shopko Stores Operating Co LLC | Durable Medical Equipment & Medical Supplies | 6355 Main St, Bonners Ferry, ID 83805-8519 | 2016-07-20 |
| 1184073520 | Shopko Stores Operating Co LLC | Durable Medical Equipment & Medical Supplies | 3402 Main St, Emmetsburg, IA 50536-1515 | 2016-06-07 |
| Street Address |
1166 W SUNSET DRIVE SUITE F100 |
| City | WAUKESHA |
| State | WI |
| Zip Code | 53189 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851841910 | Jane Knoblock | Speech-Language Pathologist | S48w23663 Merlin Ln, Waukesha, WI 53189 | 2016-10-12 |
| 1063850246 | Tracey Sue Kochanski | Nurse Practitioner | 1130 W Sunset Ave, Waukesha, WI 53189 | 2013-06-10 |
| 1376981811 | Mark Russell Schmitt | Registered Nurse | 1804 Dixie Dr., Waukesha, WI 53189 | 2013-06-06 |
| 1760738546 | Schreve and Associates Inc. | Durable Medical Equipment & Medical Supplies | 406 Travis Ln., Ste 50, Waukesha, WI 53189 | 2012-07-30 |
| 1407152879 | Kimberly Lyn Moravec | Registered Nurse | W326 S3994 Spring Ridge Ct, Waukesha, WI 53189 | 2011-02-02 |
| 1154505113 | Le Ann Le Blanc | Day Training, Developmentally Disabled Services | S31 W28251 Sunset Drive, Waukesha, WI 53189 | 2007-12-26 |
| 1801934807 | Wisconsin Vision, Inc. | Technician/Technologist | 203a Sunset Drive, Waukesha, WI 53189 | 2007-02-02 |
| 1497828172 | Donna G. Kraklow D.d.s. | Dentist | 1507 E Sunset Dr, Suite 110, Waukesha, WI 53189 | 2006-11-17 |
| 1285713461 | Robert Evan Davies | Dentist | 2117 Corporate Dr., Suite 100, Waukesha, WI 53189 | 2006-11-06 |
| 1427139542 | Wal-mart Stores East Lp | Technician/Technologist | 2000 Sw Avenue, Waukesha, WI 53189 | 2006-10-17 |
| Find all providers in zip 53189 | ||||
| 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 |
|---|---|---|---|---|
| 1548826951 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1166 W Sunset Dr # F100, Waukesha, WI 53189-8441 | 2019-05-13 |
| 1790135432 | Usv Optical Inc. | Eyewear Supplier (Equipment, not the service) | 801 E Sunset Dr, Waukesha, WI 53189-7816 | 2016-06-14 |
| 1558648006 | Visionworks, Inc. | Eyewear Supplier (Equipment, not the service) | 825 W Moreland Blvd, Waukesha, WI 53188-2963 | 2011-11-11 |
| 1366523912 | Stein Optical Inc | Eyewear Supplier (Equipment, not the service) | 825 W Moreland Blvd, Waukesha, WI 53188-2963 | 2006-10-18 |
| 1477644144 | Luxottica of America Inc | Eyewear Supplier (Equipment, not the service) | 2401 Kossow Rd, Waukesha, WI 53186-2904 | 2006-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427658772 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1073 E Johnson St, Fond Du Lac, WI 54935-8919 | 2020-10-27 |
| 1578170247 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 120 N Grand Ave Ste 102, Sun Prairie, WI 53590-9007 | 2020-09-28 |
| 1639784622 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 2268 W Mason St, Green Bay, WI 54303-4707 | 2020-09-15 |
| 1427669746 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1607 Losey Blvd S, La Crosse, WI 54601-6151 | 2020-08-11 |
| 1710598032 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 631 Hometown Cir Ste 106, Verona, WI 53593-1561 | 2020-08-11 |
| 1871138073 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 723 Main Ave, Depere, WI 54115 | 2019-11-12 |
| 1558903815 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 422 Gammon Pl, Madison, WI 53719-1026 | 2019-10-08 |
| 1669013256 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 123 N Mall Dr, Grand Chute, WI 54913-8531 | 2019-10-04 |
| 1952962763 | Martell Eyecare, LLC | Eyewear Supplier (Equipment, not the service) | 703 Third Street, Marathon, WI 54448 | 2019-06-23 |
| 1932767316 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1440 Capital Drive, Suite B, Pewaukee, WI 53072 | 2019-05-31 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on SHOPKO STORES OPERATING CO LLC.
| 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.