SHOPKO STORES OPERATING CO LLC (NPI# 1477831618) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477831618 |
| Entity Type | Organization |
| Organization Name | SHOPKO STORES OPERATING CO LLC |
| Other Organization Name | SHOPKO OPTICAL 607 |
| Practice Address |
1010 South Mainline Dr Seymour WI 54165-1451 |
| Practice Telephone | 9208330430 |
| Enumeration Date | 2011-07-21 |
| Last Update Date | 2011-10-17 |
| 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 607 | 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 |
1010 SOUTH MAINLINE DR |
| City | SEYMOUR |
| State | WI |
| Zip Code | 54165-1451 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851779789 | Kalli Vandenheuvel | Specialist/Technologist | W3068 Kortney Lane, Seymour, WI 54165 | 2015-05-12 |
| 1316110562 | Christine Sue Peterson | Occupational Therapy Assistant | W 1587 County Highway Ee, Seymour, WI 54165 | 2008-04-09 |
| 1073618849 | General Dentistry of Seymour Inc | Dentist | 344 State Hwy 54, Ste 1, Seymour, WI 54165 | 2006-09-14 |
| 1235234063 | Donald Joseph Hoff Jr. | Dentist | 344 State Highway 54, Ste 1, Seymour, WI 54165 | 2006-09-14 |
| 1871517565 | Mary Therese Leveille | Registered Nurse | 1100 Orchard St, Seymour, WI 54165 | 2006-07-26 |
| 1114995164 | Good Shepherd Home, Ltd | Physical Therapist | 958 Foote Street, Seymour, WI 54165 | 2006-03-08 |
| 1023125416 | Barbara A Pesola | Nurse Practitioner | 1100 Orchard Dr, Seymour, WI 54165 | 2006-08-23 |
| 1235106725 | Good Shepherd Home, Ltd | Assisted Living Facility | 607 E Bronson Rd, Seymour, WI 54165-1040 | 2006-03-02 |
| 1043855190 | Alissa A Huff | Spec/Tech, Pathology | 607 E Bronson Rd, Seymour, WI 54165-1040 | 2019-11-13 |
| 1508298084 | Brooke Tank | Occupational Therapy Assistant | 607 E Bronson Rd, Seymour, WI 54165-1040 | 2013-08-06 |
| Find all providers in zip 54165 | ||||
| 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 |
|---|---|---|---|---|
| 1114218377 | Louisville Optometric Centers, IIi Psc | Eyewear Supplier (Equipment, not the service) | 631 E Tipton St Ste 2, Seymour, IN 47274-3519 | 2011-04-22 |
| 1437303948 | Greg A Mcclurg | Eyewear Supplier (Equipment, not the service) | 10721 Chapman Hwy, Suite 5, Seymour, TN 37865-4765 | 2008-11-11 |
| 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.