SHOPKO STORES OPERATING CO LLC (NPI# 1871076968) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871076968 |
| Entity Type | Organization |
| Organization Name | SHOPKO STORES OPERATING CO LLC |
| Practice Address |
1810 Jackson St Oshkosh WI 54901-2204 |
| Mailing Address |
700 Pilgrim Way Green Bay WI 54304-5263 |
| Practice Telephone | 9204292211 |
| Enumeration Date | 2018-09-13 |
| Last Update Date | 2018-09-13 |
| 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 4218 | 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 |
| 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 |
1810 JACKSON ST |
| City | OSHKOSH |
| State | WI |
| Zip Code | 54901-2204 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083270490 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1810 Jackson St, Oshkosh, WI 54901-2204 | 2019-05-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023657855 | Kayla Crockett | Specialist/Technologist | Kolf Sports Center, Oshkosh, WI 54901 | 2019-12-26 |
| 1629593421 | Taymoor Sardar | Psychologist | 404 N. Main St., Suite 501, Oshkosh, WI 54901 | 2017-08-14 |
| 1821414889 | Chris Lynn Wiggs | Registered Nurse | 2150 Ontario St., Oshkosh, WI 54901 | 2014-03-13 |
| 1114359023 | Robert James Rigoni Jr. | Pharmacist | 1300 S. Koeller Rd, Oshkosh, WI 54901 | 2013-08-01 |
| 1427313386 | Scott Forrest Trippe | Psychologist | 627 Bayshore Drive, Oshkosh, WI 54901 | 2012-07-06 |
| 1003113135 | Ashley Lauren Procknow | Registered Nurse | 105 Bowen St, Oshkosh, WI 54901 | 2011-02-25 |
| 1982915963 | Benjamin Ross Goldstein | Psychiatry & Neurology | 4100 Treffert Dr., Oshkosh, WI 54901 | 2010-06-24 |
| 1982926234 | Patricia A Pendowski | Counselor | 3240 Jackson Street, Oshkosh, WI 54901 | 2010-02-26 |
| 1083867477 | Lori Marie Pierquet | Psychologist | 375 C Executive Suites, City Center, Oshkosh, WI 54901 | 2008-10-29 |
| 1346493228 | William Alexander Hammond | Dentist | 5252 I-ah-maytah Rd., Oshkosh, WI 54901 | 2008-10-23 |
| Find all providers in zip 54901 | ||||
| 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 |
|---|---|---|---|---|
| 1942866314 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1212 S Koeller St, Oshkosh, WI 54902 | 2019-05-11 |
| 1174684534 | Stellar Vision Inc | Eyewear Supplier (Equipment, not the service) | 358 S Koeller St, Oshkosh, WI 54902-5546 | 2006-12-12 |
| 1801993977 | Luxottica Retail North America Inc | Eyewear Supplier (Equipment, not the service) | 1098 S Koeller St, Koeller Ctr, Oshkosh, WI 54902-6172 | 2006-09-20 |
| 1235181298 | Shopko Stores Operating Co. LLC | Eyewear Supplier (Equipment, not the service) | 1300 S Koeller St, Oshkosh, WI 54902-6169 | 2006-05-17 |
| 1083270490 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1810 Jackson St, Oshkosh, WI 54901-2204 | 2019-05-13 |
| 1598188930 | G F Jensen | Eyewear Supplier (Equipment, not the service) | 422 N Main St, Oshkosh, WI 54901-4924 | 2014-01-21 |
| 1972941599 | G F Jensen | Eyewear Supplier (Equipment, not the service) | 422 N Main St, Oshkosh, WI 54901-4924 | 2013-06-05 |
| 1043527773 | Pearle Vision Inc | Eyewear Supplier (Equipment, not the service) | 1098 S Koeller St, Koeller Ctr, Oshkosh, WI 54902-6172 | 2010-09-01 |
| 1992969083 | Oshkosh Optical Center S. C. | Eyewear Supplier (Equipment, not the service) | 511 W Murdock Ave, Oshkosh, WI 54901-2213 | 2008-07-17 |
| 1578617957 | Ophthalmic Surgery of Wi Ltd | Eyewear Supplier (Equipment, not the service) | 509 S Washburn St, Oshkosh, WI 54904 | 2007-01-22 |
| Find all providers in OSHKOSH | ||||
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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.