Shopko Optical 105

LBN: Shopko Stores Operating Co. Llc
Shopko Optical 105 is an health care organization with primary practice located at 125 S State St , Orem UT 84058-5419. The organization recently has 3 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Optician, Suppliers / Eyewear Supplier (Equipment, not the service). Suppliers / Eyewear Supplier (Equipment, not the service) is the primary health care specialty. Shopko Stores Operating Co. Llc can be contacted via phone (801) 225-4700, or through Bettiga, Michael J via phone (920) 429-4297.

Contact Information

Primary practice address
125 S State St Orem UT 84058-5419
Fax:
Website:
Authorized official contact:
Name: Bettiga, Michael J RPH

Profile Details

NPI number 1396798161
LBN Legal business name Shopko Stores Operating Co. Llc
DBA Doing business as Shopko Optical 105
Authorized official Bettiga, Michael J RPH
Entity Organization
Organization subpart 1 No
Enumeration date May 19th, 2006
Last updated Jul 10th, 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 1396798161 NPPES
Other 014105 VIP
Other CP2230-46 VIP
Other 35528 VIP
MEDICAID 410985054-196 VIP
Other UT04884 VIP
Other 17928 VIP
Other 42586 VIP

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