SHOPKO STORES OPERATING CO LLC (NPI# 1346569183) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346569183 |
| Entity Type | Organization |
| Organization Name | SHOPKO STORES OPERATING CO LLC |
| Other Organization Name | SHOPKO OPTICAL 602 |
| Practice Address |
126 Charles St Oconto WI 54153-9446 |
| Practice Telephone | 9208341111 |
| Practice Fax Number | 9208349801 |
| Mailing Telephone | 9208341111 |
| Mailing Fax Number | 9208349801 |
| Enumeration Date | 2010-05-19 |
| Last Update Date | 2011-07-26 |
| Authorized Official Name | MR. MICHAEL BETTIGA (EXECUTIVE VICE PRESIDENT AND COO) |
| 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 |
| Other Name | Type Code |
|---|---|
| ShopKo Optical 602 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275017907 | Shopko Stores Operating Co LLC | Eyewear Supplier (Equipment, not the service) | 1166 W Sunset Drive, Suite F100, Waukesha, WI 53189 | 2018-09-19 |
| 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 |
| Street Address |
126 CHARLES ST |
| City | OCONTO |
| State | WI |
| Zip Code | 54153-9446 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982922860 | Shopko Stores Operating Co LLC | Durable Medical Equipment & Medical Supplies | 126 Charles St, Oconto, WI 54153-9446 | 2010-05-17 |
| 1194155267 | Thomas Lotter Sr. | Pharmacist | 126 Charles St, Oconto, WI 54153-9446 | 2013-11-26 |
| 1265878110 | Shopko #602 | Pharmacy | 126 Charles St, Oconto, WI 54153-9446 | 2013-05-20 |
| 1154617652 | Jaclyn Ann Keller | Optometrist | 126 Charles St, Oconto, WI 54153-9446 | 2011-06-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629240650 | Aurora Medical Group Inc | Durable Medical Equipment & Medical Supplies | 530 Smith Ave, Oconto, WI 54153 | 2008-03-31 |
| 1912997081 | Benzer Wi 1 LLC | Pharmacy | 1008 Main St, Oconto, WI 54153 | 2005-10-28 |
| 1245758127 | Hayley Joy Maxwell | Counselor | 501 Park Ave, Oconto, WI 54153 | 2017-08-31 |
| 1538542089 | Aliaksandr Trusau | Internal Medicine | 620 Smith Ave, Oconto, WI 54153 | 2015-07-01 |
| 1467879296 | Christopher Hanke | Counselor | 501 Park Ave, Oconto, WI 54153 | 2014-03-18 |
| 1669807020 | Joshua Ammon Weenig | Dentist | 1210 Pecor St, Oconto, WI 54153 | 2013-09-04 |
| 1609050798 | Bellin Psychiatric Center Inc | Clinic/Center | 820 Arbutus Ave, Oconto, WI 54153 | 2007-12-26 |
| 1932252533 | Oconto County Health & Human Services | Registered Nurse | 501 Park Ave, Oconto, WI 54153 | 2007-01-19 |
| 1841343449 | Oconto County Health & Human Services | Hospice Care, Community Based | 501 Park Ave, Oconto, WI 54153 | 2007-01-19 |
| 1457425951 | Lori Jo Eklund Walsh | Counselor | 820 Arbutus Ave, Oconto, WI 54153 | 2006-11-17 |
| Find all providers in zip 54153 | ||||
| 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 |
|---|---|---|---|---|
| 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 | ||||
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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.