SHOPKO STORES OPERATING CO. LLC (NPI# 1396797544) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396797544 |
| Entity Type | Organization |
| Organization Name | SHOPKO STORES OPERATING CO. LLC |
| Other Organization Name | SHOPKO OPTICAL 039 |
| Practice Address |
4200 S 27th St Lincoln NE 68502-5858 |
| Practice Telephone | 4024212555 |
| Mailing Telephone | 4024212555 |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2008-02-11 |
| Authorized Official Name | 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 |
|---|---|---|---|
| NE | 10025073900 | 05 | |
| AVESIS | 35497 | 01 | |
| EYEMED | 213121-24 | 01 | |
| DAVIS | 35859 | 01 | |
| BLOCK | 007121 | 01 | |
| VIP | 014039 | 01 | |
| MEDICARE | 17883 | 01 |
| Other Name | Type Code |
|---|---|
| ShopKo Optical 039 | 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 |
4200 S 27TH ST |
| City | LINCOLN |
| State | NE |
| Zip Code | 68502-5858 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093766362 | Shopko Stores Operating Co LLC | Durable Medical Equipment & Medical Supplies | 4200 S 27th St, Lincoln, NE 68502-5858 | 2006-05-12 |
| 1861058232 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 4200 S 27th St, Lincoln, NE 68502-5858 | 2019-05-11 |
| 1679139042 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 4200 S 27th St, Lincoln, NE 68502-5858 | 2019-05-11 |
| 1669423869 | Anthony James Manthey | Optometrist | 4200 S 27th St, Lincoln, NE 68502-5858 | 2006-05-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982228524 | Denison J Salisbury | Chiropractor | 3121 South 11th St, Lincoln, NE 68502 | 2020-05-29 |
| 1194207142 | Stephanie Delgado | Counselor | 1640 Lake Street, Lincoln, NE 68502 | 2018-09-05 |
| 1598259640 | Jh Wellness Services, LLC | Social Worker | 2737 S 12th St, Lincoln, NE 68502 | 2018-06-20 |
| 1508365776 | Karen Sloboda | Chiropractor | 3121 South 11th Street, Lincoln, NE 68502 | 2018-02-02 |
| 1417472762 | Nusp1, P.C. | Chiropractor | 3245 Pioneers Blvd, Lincoln, NE 68502 | 2017-08-08 |
| 1467976308 | Bryan Health Connect | Preferred Provider Organization | 2300 S 16th Street, Lincoln, NE 68502 | 2017-08-02 |
| 1235586348 | Justin Cook | Chiropractor | 3121 S. 11th St., Lincoln, NE 68502 | 2016-05-18 |
| 1316319924 | Cari Musgrove | Pharmacist | 2300 So 16th St, Bryan West Pharmacy, Lincoln, NE 68502 | 2015-10-22 |
| 1164866976 | Trevor Gregath | Psychiatry & Neurology | 2222 S 16th St Ste 340, Lincoln, NE 68502 | 2013-04-23 |
| 1023374808 | Nebraska Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 1550 South St L, Lincoln, NE 68502 | 2012-04-06 |
| Find all providers in zip 68502 | ||||
| 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 |
|---|---|---|---|---|
| 1841856234 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 2801 Pine Lake Rd Ste J, Lincoln, NE 68516-6041 | 2019-05-12 |
| 1679921720 | Statton Optical | Eyewear Supplier (Equipment, not the service) | 4645 Normal Blvd Ste 132, Lincoln, NE 68506-5823 | 2016-05-31 |
| 1790933083 | Wal-mart Stores, Inc. | Eyewear Supplier (Equipment, not the service) | 3400 North 85th St., Lincoln, NE 68507 | 2008-08-29 |
| 1225219751 | Eyeworks Inc | Eyewear Supplier (Equipment, not the service) | 1101 S 70th St Ste 200, Lincoln, NE 68510-4293 | 2007-11-27 |
| 1427239672 | Modern Eyecare Inc. | Eyewear Supplier (Equipment, not the service) | 1650 S 70th St Ste 201, Lincoln, NE 68506-1569 | 2007-11-15 |
| 1740480433 | Heartland Optical Inc. | Eyewear Supplier (Equipment, not the service) | 1012 N 27th St, Lincoln, NE 68503-1802 | 2007-07-20 |
| 1568592525 | National Vision, Inc. | Eyewear Supplier (Equipment, not the service) | 5555 'o' Street, Lincoln, NE 68510 | 2007-03-07 |
| 1447386685 | Vision Associates Inc | Eyewear Supplier (Equipment, not the service) | 125 S 66th St, Lincoln, NE 68510-2302 | 2007-02-24 |
| 1083760847 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 2950 Pine Lake Rd Ste H, Lincoln, NE 68516-6020 | 2007-01-26 |
| 1245396829 | Vision Associates Inc | Eyewear Supplier (Equipment, not the service) | 1201 O St, Suite 100, Lincoln, NE 68508-1420 | 2006-12-28 |
| Find all providers in LINCOLN | ||||
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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.