SHOPKO STORES OPERATING CO LLC (NPI# 1821343401) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821343401 |
| Entity Type | Organization |
| Organization Name | SHOPKO STORES OPERATING CO LLC |
| Other Organization Name | SHOPKO OPTICAL 788 |
| Practice Address |
200 Commerce Dr Columbus WI 53925 |
| Practice Telephone | 9204297137 |
| Enumeration Date | 2012-07-19 |
| Last Update Date | 2012-07-27 |
| Authorized Official Name | 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 788 | 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 |
200 COMMERCE DR |
| City | COLUMBUS |
| State | WI |
| Zip Code | 53925 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447594478 | Jamine Kurth | Pharmacist | 200 Commerce Dr, Columbus, WI 53925-9567 | 2012-11-15 |
| 1174876882 | Nicholas L Sharrow | Pharmacist | 200 Commerce Dr, Columbus, WI 53925-9567 | 2012-10-18 |
| 1497003594 | Shopko Stores Operating Co LLC | Durable Medical Equipment & Medical Supplies | 200 Commerce Dr, Columbus, WI 53925-9567 | 2012-08-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275833659 | Beaver Dam Community Hosptials, Inc. | Family Medicine | 1580 W James St, Columbus, WI 53925 | 2010-11-01 |
| 1497972749 | Droessler Chiropractic Sc | Chiropractor | 1349 Park Avenue, Columbus, WI 53925 | 2007-04-19 |
| 1164487328 | Drs Beck & Becker Sc | Dentist | 1505 Park Ave., Columbus, WI 53925 | 2006-04-19 |
| 1245864735 | Margaret Mary Frank | Pharmacist | 1500 W James St, Columbus, WI 53925 | 2020-02-24 |
| 1487094686 | Tiana M Imhoff | Physician Assistant | 1515 Park Ave, Columbus, WI 53925 | 2013-07-02 |
| 1689987372 | Erin Renee Hills | Nurse Practitioner | 1515 Park Ave, Columbus, WI 53925 | 2010-07-22 |
| 1184723645 | James Michael Beck | Dentist | 1505 Park Ave., Columbus, WI 53925 | 2006-09-21 |
| 1194824649 | William James Becker | Dentist | 1505 Park Ave., Columbus, WI 53925 | 2006-09-21 |
| 1225004245 | Nazi S Khan | Internal Medicine | 1511 Park Ave, Columbus, WI 53925 | 2006-02-28 |
| 1689756157 | Walgreen Co | Pharmacy | 1500 W James St, Columbus, WI 53925-1001 | 2006-10-20 |
| Find all providers in zip 53925 | ||||
| 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 |
|---|---|---|---|---|
| 1982245262 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 4049 The Strand E, Columbus, OH 43219-6131 | 2019-10-08 |
| 1366931792 | Jand Inc | Eyewear Supplier (Equipment, not the service) | 601 High Street, Space 101, Columbus, OH 43215 | 2018-05-01 |
| 1972957561 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 5279 Whittlesey Blvd, Suite 100, Columbus, GA 31909-3073 | 2016-04-20 |
| 1811384746 | Visionworks, Inc | Eyewear Supplier (Equipment, not the service) | 4142 Seward Street, Suite F105, Columbus, OH 43219 | 2015-04-17 |
| 1578961561 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 4038 Morse Rd, Columbus, OH 43219-3018 | 2014-12-08 |
| 1811300049 | West Point Optical LLC | Eyewear Supplier (Equipment, not the service) | 3775 Easton Way, Columbus, OH 43219-6149 | 2014-06-05 |
| 1902228331 | Visionworks, Inc | Eyewear Supplier (Equipment, not the service) | 1279 Polaris Pkwy, Columbus, OH 43240-2037 | 2014-01-21 |
| 1073811980 | Vision Eye Care | Eyewear Supplier (Equipment, not the service) | 2505l Airport Thruway, Columbus, GA 31904 | 2011-03-02 |
| 1467760652 | Arlington Contact Lens Service, Inc | Eyewear Supplier (Equipment, not the service) | 4265 Diplomacy Dr, Columbus, OH 43228-3834 | 2010-09-22 |
| 1952633455 | Eyemart Express | Eyewear Supplier (Equipment, not the service) | 1141 Polaris Pkwy, Columbus, OH 43240-6045 | 2010-02-08 |
| Find all providers in COLUMBUS | ||||
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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.