Shopko Stores Operating Company

LBN: Shopko Stores Operating Company
Shopko Stores Operating Company is an health care organization with primary practice located at 2430 E Mason St , Green Bay WI 54302-3759. The organization recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as the primary health care specialty. Shopko Stores Operating Company can be contacted via phone (920) 468-4642, or through Schmonsky, James L via phone (920) 468-4642.

Contact Information

Primary practice address
2430 E Mason St Green Bay WI 54302-3759
Phone: (920) 468-4642
Fax: (920) 468-3490
Website:
Map and Directions
Authorized official contact:
Name: Schmonsky, James L Doctor of Optometry (OD)
Phone: (920) 468-4642

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 1643-035 Wisconsin

Profile Details

NPI number 1962452052
LBN Legal business name Shopko Stores Operating Company
DBA Doing business as
Authorized official Schmonsky, James L Doctor of Optometry (OD)
Entity Organization
Organization subpart 1 No
Enumeration date May 11th, 2006
Last updated Aug 22nd, 2020 - about 6 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 1962452052 NPPES
Wisconsin MEDICAID 38403100

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