Shopko Optical Manufacturing Llc

LBN: Shopko Optical Manufacturing Llc
Shopko Optical Manufacturing Llc is an health care organization with primary practice located at 1450 W Main Ave , De Pere WI 54115-9369. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Eyewear Supplier (Equipment, not the service). Suppliers / Eyewear Supplier (Equipment, not the service) is the primary health care specialty. Shopko Optical Manufacturing Llc can be contacted via phone (920) 429-7253, or through Bettiga, Michael via phone (920) 429-4297.

Contact Information

Primary practice address
1450 W Main Ave De Pere WI 54115-9369
Fax:
Website:
Authorized official contact:
Name: Bettiga, Michael RPH

Health care specialties

Profile Details

NPI number 1821243650
LBN Legal business name Shopko Optical Manufacturing Llc
DBA Doing business as
Authorized official Bettiga, Michael RPH
Entity Organization
Organization subpart 1 No
Enumeration date Nov 20th, 2008
Last updated Feb 24th, 2009 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821243650 NPPES
Wisconsin MEDICAID 38456800

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