Shopko Optical 145

LBN: Shopko Stores Operating Co. Llc
Shopko Optical 145 is an health care organization with primary practice located at 1190 N 6Th St , Monmouth IL 61462-9672. The organization recently has only one registered license in Suppliers / Eyewear Supplier (Equipment, not the service), which is considered as the primary health care specialty. Shopko Stores Operating Co. Llc can be contacted via phone (309) 734-7576, or through Bettiga, Michael J via phone (920) 429-4297.

Contact Information

Primary practice address
1190 N 6Th St Monmouth IL 61462-9672
Phone: (309) 734-7576
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Bettiga, Michael J RPH
Phone: (920) 429-4297

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Eyewear Supplier (Equipment, not the service) 332H00000X

Profile Details

NPI number 1295788842
LBN Legal business name Shopko Stores Operating Co. Llc
DBA Doing business as Shopko Optical 145
Authorized official Bettiga, Michael J RPH
Entity Organization
Organization subpart 1 No
Enumeration date May 17th, 2006
Last updated Jun 4th, 2008 - about 18 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 1295788842 NPPES
Other 17687 MEDICARE
Other CP2521-4 MEDICARE
Other 014145 MEDICARE
Other 35457 MEDICARE
Other 5232016 MEDICARE
Other 42562 MEDICARE

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