SHOPKO STORES OPERATING CO. LLC (NPI# 1306899174) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1306899174 |
Entity Type | Organization |
Organization Name | SHOPKO STORES OPERATING CO. LLC |
Other Organization Name | SHOPKO OPTICAL 078 |
Practice Address |
1845 Haines Ave Rapid City SD 57701-0663 |
Practice Telephone | 6053420354 |
Mailing Telephone | 6053420354 |
Enumeration Date | 2006-05-19 |
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 | 35518 | 01 | |
EYEMED | CP2230-37 | 01 | |
MEDICARE | 17914 | 01 | |
VIP | 014078 | 01 |
Other Name | Type Code |
---|---|
ShopKo Optical 078 | 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 |
1124071568 | Shopko Stores Operating Co. LLC | Eyewear Supplier (Equipment, not the service) | 500 N Hwy 281, Aberdeen, SD 57401-1821 | 2006-05-18 |
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 |
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 |
1845 HAINES AVE |
City | RAPID CITY |
State | SD |
Zip Code | 57701-0663 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1952352544 | Shopko Stores Operating Co LLC | Durable Medical Equipment & Medical Supplies | 1845 Haines Ave, Rapid City, SD 57701-0663 | 2006-05-16 |
1699728766 | Greg Sorensen | Optometrist | 1845 Haines Ave, Rapid City, SD 57701-0663 | 2006-05-18 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1528623345 | Julie Maas | Counselor | 625 1/2 Main St, Suite 1, Rapid City, SD 57701 | 2019-05-07 |
1972076024 | Edgewood Rapid City LLC | Assisted Living Facility | 4001 Derby Lane, Rapid City, SD 57701 | 2019-01-10 |
1902300247 | Theresa Gibbens | Speech-Language Pathologist | 3301 Grandview Drive, Rapid City, SD 57701 | 2018-03-21 |
1407355423 | Arielle Leigh Loveridge | Chiropractor | 610 East Boulevard, Suite 1, Rapid City, SD 57701 | 2018-02-05 |
1083125082 | Sarah Kirschman | Nurse Practitioner | 353 Fairmont Boulvevard, Rapid City, SD 57701 | 2017-10-17 |
1992225239 | Kelsey Elizabeth Wondercheck | Dentist | 717 Meade Street, Suite 200, Rapid City, SD 57701 | 2017-06-27 |
1316476088 | Rhianna Wickett | Physical Therapist | 420 E Saint Patrick St Ste 101, Rapid City, SD 57701 | 2017-06-07 |
1841727773 | Cynthia A Gates | Dietitian, Registered | 2908 5th Street, Rapid City, SD 57701 | 2017-05-23 |
1811447758 | Alyssa Marquardt | Psychologist | 433 Mt. Rushmore Road, Rapid City, SD 57701 | 2016-10-04 |
1578913232 | .indian Health Service | Clinic/Center | 241 East Meade St, Rapid City, SD 57701 | 2016-06-14 |
Find all providers in zip 57701 |
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 |
---|---|---|---|---|
1427249721 | Essilor Laboratories of America, Inc | Eyewear Supplier (Equipment, not the service) | 109 New York St, Rapid City, SD 57701-1154 | 2007-08-05 |
1760589774 | Luxottica Retail North America Inc | Eyewear Supplier (Equipment, not the service) | 2200 N Maple, Rushmore Mall, Rapid City, SD 57701-7854 | 2006-09-20 |
1942217674 | Usv Optical Inc. | Eyewear Supplier (Equipment, not the service) | 2200 N. Maple Avenue, Rapid City, SD 57701 | 2006-08-02 |
1043259930 | Independent Optical, Inc | Eyewear Supplier (Equipment, not the service) | 810 Mount Rushmore Rd, Rapid City, SD 57701-3603 | 2006-06-06 |
1205874252 | National Vision, Inc. | Eyewear Supplier (Equipment, not the service) | 1200 N Lacrosse St, Rapid City, SD 57701-6984 | 2006-06-03 |
1194123158 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 1605 Eglin St, Rapid City, SD 57701-6107 | 2014-12-08 |
1437555182 | Pillen Optical Inc | Eyewear Supplier (Equipment, not the service) | 409 Kansas City St, Rapid City, SD 57701-8239 | 2014-11-07 |
1659509107 | Eyemart Express Ltd | Eyewear Supplier (Equipment, not the service) | 1605 Eglin St, Rapid City, SD 57701-6107 | 2009-06-23 |
1487797320 | Your Eyes Only Optical, Inc | Eyewear Supplier (Equipment, not the service) | 240 Minnesota St, Rapid City, SD 57701-6200 | 2007-02-14 |
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 |
1588220958 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 3307 7th Ave Se Ste 105, Aberdeen, SD 57401-6613 | 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 |
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 |
City | RAPID CITY |
Zip Code | 57701 |
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.