SHOPKO STORES OPERATING CO. LLC (NPI# 1346292745) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346292745 |
| Entity Type | Organization |
| Organization Name | SHOPKO STORES OPERATING CO. LLC |
| Other Organization Name | SHOPKO OPTICAL 029 |
| Practice Address |
7401 Mineral Point Rd Madison WI 53717 |
| Mailing Address |
7401 Mineral Point Rd Madison WI 53717-1703 |
| Practice Telephone | 6088335700 |
| Mailing Telephone | 6088335700 |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2018-06-08 |
| Authorized Official Name | DILIP SEDANI (E) |
| 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 |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AVESIS | 35571 | 01 | |
| WI | 38412900 | 05 | |
| DAVIS | 42622 | 01 | |
| MEDICARE | 000087848 | 01 | |
| EYEMED | CP2230-76 | 01 | |
| MEDICARE | 17647 | 01 | |
| NVA | 410985054-4029 | 01 | |
| VIIP | 014029 | 01 |
| Other Name | Type Code |
|---|---|
| ShopKo Optical 029 | 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 |
7401 MINERAL POINT RD |
| City | MADISON |
| State | WI |
| Zip Code | 53717 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740625862 | Cynthia Eileen Liebau | Pharmacist | 7401 Mineral Point Rd, Madison, WI 53717-1703 | 2013-05-02 |
| 1497933410 | Beata Malgorzata Nowak | Pharmacist | 7401 Mineral Point Rd, Shopko Pharmacy, Madison, WI 53717-1703 | 2008-01-31 |
| 1255518676 | Martha Lee Girdaukas | Pharmacist | 7401 Mineral Point Rd, Madison, WI 53717-1703 | 2008-01-28 |
| 1154366847 | James Michael Rewey | Physician Assistant | 7401 Mineral Point Rd, Madison, WI 53715-1596 | 2006-06-18 |
| 1891741245 | Shopko Stores Operating Co LLC | Durable Medical Equipment & Medical Supplies | 7401 Mineral Point Rd, Madison, WI 53717 | 2006-05-26 |
| 1932151313 | Ken Thue | Optometrist | 7401 Mineral Point Rd, Madison, WI 53717-1703 | 2006-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720540164 | Apex Chiropractic Center LLC | Chiropractor | 562 Junction Road, Madison, WI 53717 | 2019-04-04 |
| 1467943795 | Brittany Macrander | Speech-Language Pathologist | 701 Deming Way, Madison, WI 53717 | 2018-05-22 |
| 1144622614 | Christopher Leclair | Pharmacist | 7942 Tree Ln, Suite 201, Madison, WI 53717 | 2014-09-16 |
| 1740617430 | Martha Darlene Kniffin | Marriage & Family Therapist | 1805 Excelsior Dr, The Family Center, Madison, WI 53717 | 2013-09-26 |
| 1740538305 | Amber J Thompson | Specialist | 8202 Excelisor Dr, Madison, WI 53717 | 2012-08-29 |
| 1457622938 | Kimberly F Lauth | Physician Assistant | 1200 Q Hammons Drive, Suite 400, Madison, WI 53717 | 2012-01-16 |
| 1699042499 | Cameron K Birch | Pharmacist | 9741 Tree Lane, Suite 201, Madison, WI 53717 | 2011-11-22 |
| 1508023102 | Katherine Jo Hartkopf | Pharmacist | 8501 Excelsior Drive, Rm. 337, Madison, WI 53717 | 2008-05-21 |
| 1366614885 | Periodontal & Implant Specialists of Madison, LLC | Dentist | 49 N Walbridge Ave., Madison, WI 53717 | 2008-03-25 |
| 1598961005 | John H Greist | Psychiatry & Neurology | Healthcare Technology Systems, Inc., 7617 Mineral Point Rd., Ste. 300, Madison, WI 53717 | 2007-06-22 |
| Find all providers in zip 53717 | ||||
| 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 |
|---|---|---|---|---|
| 1558903815 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 422 Gammon Pl, Madison, WI 53719-1026 | 2019-10-08 |
| 1871159251 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 3868 E Washington Ave Ste F, Madison, WI 53704-3600 | 2019-05-11 |
| 1245785948 | Wisconsin Council of The Blind and Visually Impaired, Inc | Eyewear Supplier (Equipment, not the service) | 754 Williamson St, Madison, WI 53703-3546 | 2016-08-23 |
| 1639573264 | Moore Vision Center, Pllc | Eyewear Supplier (Equipment, not the service) | 467 Main St Ste 401, Madison, WV 25130-2200 | 2014-10-10 |
| 1073785796 | The Eyeglass Shoppe of Madison, Inc. | Eyewear Supplier (Equipment, not the service) | 26 Waverly Pl, Madison, NJ 07940-1807 | 2008-04-02 |
| 1457520553 | Donch and Baker, O.d. Eye Doctors of Madison, LLC | Eyewear Supplier (Equipment, not the service) | 103 N Lake St, Madison, OH 44057-3115 | 2008-02-22 |
| 1942323795 | Dean Retail Services, Inc. | Eyewear Supplier (Equipment, not the service) | 1821 S Stoughton Rd Ste 200, Madison, WI 53716-2257 | 2007-04-09 |
| 1003941188 | Eyecare Associates, Inc. | Eyewear Supplier (Equipment, not the service) | 7880 Madison Pike, Madison, AL 35758-1435 | 2007-02-22 |
| 1427102441 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 29 E Towne Mall, Madison, WI 53704-3711 | 2007-01-23 |
| 1538213848 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 1 W Towne Mall # C59, Madison, WI 53719 | 2007-01-23 |
| Find all providers in MADISON | ||||
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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.