SHOPTIKAL LLC (NPI# 1922664358) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922664358 |
| Entity Type | Organization |
| Organization Name | SHOPTIKAL LLC |
| Other Organization Name | SHOPKO OPTICAL 4018 |
| Practice Address |
1745 South Main St West Bend WI 53095 |
| Mailing Address |
Po Box 19060 Green Bay WI 54307-9060 |
| Practice Telephone | 2623347077 |
| Enumeration Date | 2019-05-10 |
| Last Update Date | 2019-07-12 |
| Authorized Official Name | JAMES E EISEN (OPERATING PARTNER) |
| Authorized Official Telephone | 9204297549 |
| 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 4018 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427658772 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1073 E Johnson St, Fond Du Lac, WI 54935-8919 | 2020-10-27 |
| 1801493903 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 11995 Business Park Blvd N, Champlin, MN 55316 | 2020-10-02 |
| 1578170247 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 120 N Grand Ave Ste 102, Sun Prairie, WI 53590-9007 | 2020-09-28 |
| 1174138168 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1550 W Lane Rd, Machesney Park, IL 61115-1903 | 2020-09-15 |
| 1639784622 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 2268 W Mason St, Green Bay, WI 54303-4707 | 2020-09-15 |
| 1588279566 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1190 S Randall Rd Ste 104, Elgin, IL 60123-4110 | 2020-09-15 |
| 1427669746 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1607 Losey Blvd S, La Crosse, WI 54601-6151 | 2020-08-11 |
| 1710598032 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 631 Hometown Cir Ste 106, Verona, WI 53593-1561 | 2020-08-11 |
| 1457989006 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 3330 E 10th St, Sioux Falls, SD 57103-2107 | 2020-03-30 |
| 1710512801 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 9940 Rt 47, Huntley, IL 60142 | 2020-03-09 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | SHOPTIKAL LLC | 700 Pilgrim Way, Green Bay, WI 54304 |
| Iowa Business Entities | SHOPTIKAL LLC | 700 Pilgrim Way, Green Bay, WI 54304 |
| Washington State Corporations | SHOPTIKAL LLC | 700 Pilgrim Way, Green Bay, WI 54304-5263 |
| Street Address |
1745 SOUTH MAIN ST |
| City | WEST BEND |
| State | WI |
| Zip Code | 53095 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942820428 | David Fountain | Contractor | 726 Creedwood Lane, West Bend, WI 53095 | 2020-04-24 |
| 1912423773 | Michelle R Prentice | Family Medicine | West Bend Health Center, 1700 W. Paradise Drive, West Bend, WI 53095 | 2017-08-14 |
| 1386165918 | Quad/med, LLC | Clinic/Center | 432 E. Washington St. #1115, West Bend, WI 53095 | 2017-07-05 |
| 1508230632 | Jesen Daniel | Counselor | 111 East Washington St, Affiliated Clinical Services, West Bend, WI 53095 | 2015-12-01 |
| 1477965259 | Jenna Crofts | Specialist/Technologist | 1190 East Paradise Drive, West Bend, WI 53095 | 2014-05-28 |
| 1023436342 | Visionworks | Optometrist | 1437 S. Main St., West Bend, WI 53095 | 2014-04-03 |
| 1295157295 | Stephanie Rabe | Registered Nurse | 910 E. Paradise Drive, West Bend, WI 53095 | 2014-01-09 |
| 1477898815 | Ralph Norman Olsen | Pediatrics | 6267 Riesch Road, West Bend, WI 53095 | 2012-12-11 |
| 1932458536 | Joshua Aaron Barta | Dentist | 2090 Continental Drive, West Bend, WI 53095 | 2012-08-29 |
| 1972851715 | Joan Marie Kutz | Registered Nurse | 910 East Paradise Drive, West Bend, WI 53095 | 2012-08-28 |
| Find all providers in zip 53095 | ||||
| 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 |
|---|---|---|---|---|
| 1609957620 | Stein Optical Inc | Eyewear Supplier (Equipment, not the service) | 1437 S. Main Street, West Bend, WI 53095 | 2006-10-17 |
| 1326090341 | Shopko Stores Operating Co. LLC | Eyewear Supplier (Equipment, not the service) | 1710 S Main St, West Bend, WI 53095-4938 | 2006-05-17 |
| 1730466277 | Visionworks, Inc. | Eyewear Supplier (Equipment, not the service) | 1437 S Main St, West Bend, WI 53095-4931 | 2011-11-11 |
| 1710289608 | Earl W Nepple M.d. | Eyewear Supplier (Equipment, not the service) | 1201 Oak St, West Bend, WI 53095-3800 | 2010-11-26 |
| 1881749919 | West Bend Clinic | Eyewear Supplier (Equipment, not the service) | 1700 W Paradise Dr, West Bend, WI 53095-9795 | 2007-01-25 |
| 1285654012 | Aurora Health Care Ventures, Inc. | Eyewear Supplier (Equipment, not the service) | 205 Valley Ave, West Bend, WI 53095-5312 | 2006-07-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427658772 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1073 E Johnson St, Fond Du Lac, WI 54935-8919 | 2020-10-27 |
| 1578170247 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 120 N Grand Ave Ste 102, Sun Prairie, WI 53590-9007 | 2020-09-28 |
| 1639784622 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 2268 W Mason St, Green Bay, WI 54303-4707 | 2020-09-15 |
| 1427669746 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1607 Losey Blvd S, La Crosse, WI 54601-6151 | 2020-08-11 |
| 1710598032 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 631 Hometown Cir Ste 106, Verona, WI 53593-1561 | 2020-08-11 |
| 1871138073 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 723 Main Ave, Depere, WI 54115 | 2019-11-12 |
| 1558903815 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 422 Gammon Pl, Madison, WI 53719-1026 | 2019-10-08 |
| 1669013256 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 123 N Mall Dr, Grand Chute, WI 54913-8531 | 2019-10-04 |
| 1952962763 | Martell Eyecare, LLC | Eyewear Supplier (Equipment, not the service) | 703 Third Street, Marathon, WI 54448 | 2019-06-23 |
| 1932767316 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1440 Capital Drive, Suite B, Pewaukee, WI 53072 | 2019-05-31 |
| Find all providers with the same taxonomy | ||||
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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.