SHOPKO STORES OPERATING CO. LLC (NPI# 1265483572) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265483572 |
| Entity Type | Organization |
| Organization Name | SHOPKO STORES OPERATING CO. LLC |
| Other Organization Name | SHOPKO OPTICAL 094 |
| Practice Address |
955 Bailey Hill Rd Eugene OR 97402-5486 |
| Practice Telephone | 5416860857 |
| Mailing Telephone | 5416860857 |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. 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 |
|---|---|---|---|
| OR | 006929 | 05 | |
| EYEMED | CP2230-34 | 01 | |
| OR | OMAP | 05 | |
| DAVIS VISION | 42576 | 01 | |
| VIP | 014094 | 01 |
| Other Name | Type Code |
|---|---|
| ShopKo Optical 094 | 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 |
955 BAILEY HILL RD |
| City | EUGENE |
| State | OR |
| Zip Code | 97402-5486 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720030240 | Shopko Stores Operating Co. LLC | Pharmacy | 955 Bailey Hill Rd, Eugene, OR 97402-5486 | 2006-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538709704 | Jordan Charles Smith | Massage Therapist | 775 Menroe St., Eugene, OR 97402 | 2020-01-15 |
| 1104462134 | Cerridwen Laurel Martin | Massage Therapist | 775 Monroe St., Eugene, OR 97402 | 2019-11-25 |
| 1720556368 | Valerie Jeanne Charles | Massage Therapist | 989 Throne Dr., Eugene, OR 97402 | 2018-11-12 |
| 1407324189 | Laura Angulo | Massage Therapist | 1247 W 8th Ave Apt 10, Eugene, OR 97402 | 2018-11-11 |
| 1932687472 | Karl Alan Porter | Counselor | 1195 City View St Ste B, Eugene, OR 97402 | 2018-08-06 |
| 1992283170 | Fresenius Medical Care Dialysis Services - Oregon, LLC | Clinic/Center | 3747 W 11th Ave, Eugene, OR 97402 | 2018-07-31 |
| 1699251744 | Isabella Arlo Jane Silver | Counselor | 970 W 7th Ave., Eugene, OR 97402 | 2018-07-12 |
| 1447740527 | Shasta Tobi Cooke | Behavioral Analyst | 677 1/2 W 12th Ave, Eugene, OR 97402 | 2018-05-15 |
| 1497205306 | Jenna Bracco | Social Worker | 1274 W. 7th Avenue Suite 201, Eugene, OR 97402 | 2016-10-04 |
| 1871041392 | Jeremy Powers | Massage Therapist | 882 Van Buren St, Eugene, OR 97402 | 2016-09-13 |
| Find all providers in zip 97402 | ||||
| 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 |
|---|---|---|---|---|
| 1043449895 | Eyemart Express, Ltd. | Eyewear Supplier (Equipment, not the service) | 1680 Coburg Rd, Suite100, Eugene, OR 97401-4869 | 2009-07-14 |
| 1659426021 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 400 Valley River Ctr, Eugene, OR 97401-2124 | 2007-01-24 |
| 1023106655 | Visionworks, Inc. | Eyewear Supplier (Equipment, not the service) | 265 Valley River Ctr, Eugene, OR 97401-2176 | 2006-10-10 |
| 1679595656 | Usv Optical Inc | Eyewear Supplier (Equipment, not the service) | 300 Valley River Ctr, Eugene, OR 97401-2151 | 2006-07-25 |
| 1881645190 | Shopko Stores Operating Co LLC | Eyewear Supplier (Equipment, not the service) | 2815 Chad Dr, Eugene, OR 97408-7335 | 2006-05-12 |
| 1912386004 | Eugene Eye Clinic LLC | Eyewear Supplier (Equipment, not the service) | 2460 Willamette St, Eugene, OR 97405-3169 | 2015-05-22 |
| 1427448067 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 2828 Chad Dr, Eugene, OR 97408-7336 | 2015-02-04 |
| 1629476601 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 1680 Coburg Rd, Ste 100, Eugene, OR 97401-4869 | 2014-12-08 |
| 1386814333 | Peacehealth Medical Group | Eyewear Supplier (Equipment, not the service) | 1162 Willamette St, Eugene, OR 97401-3568 | 2008-03-06 |
| 1679751184 | John D Wellwood | Eyewear Supplier (Equipment, not the service) | 1350 Chambers St, Eugene, OR 97402-3728 | 2008-02-06 |
| Find all providers in EUGENE | ||||
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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.