Shopko Stores Operating Co. Llc is a
Eyewear Supplier based in Salt Lake City, Utah. Shopko Stores Operating Co. Llc is licensed to practice in * (Not Available) (license number ) and their current practice location is
5800 S Redwood Rd, Salt Lake City, Utah. It can be reached at their office (for appointments etc.) via phone at
(801) 964-1300.
NPI number for Shopko Stores Operating Co. Llc is 1861444010 and their current mailing address is 5800 S Redwood Rd, Salt Lake City, Utah. Shopko Stores Operating Co. Llc
does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1861444010.
Healthcare Provider's Profile
| Full Name | Shopko Stores Operating Co. Llc |
|---|
| Type | Facility |
|---|
| Speciality | Eyewear Supplier |
|---|
| Location | 5800 S Redwood Rd, Salt Lake City, Utah |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1861444010
- Provider Enumeration Date: 05/16/2006
- Last Update Date: 07/10/2008
Medical Identifiers
Medical identifiers for Shopko Stores Operating Co. Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1861444010 | NPI | - | NPPES |
| 014085 | Other | | VIP |
| CP2230-49 | Other | | EYEMED |
| UT04882 | Other | UT | NORIDIAN SUBMITTER ID |
| 17919 | Other | | MEDICARE |
| 410985054-098 | Medicaid | UT | |
| 42545 | Other | | DAVIS |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 152W00000X | Optometrist | (* (Not Available)) | Secondary |
| 156FX1800X | Technician/technologist - Optician | (* (Not Available)) | Secondary |
| 332H00000X | Eyewear Supplier | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Shopko Stores Operating Co. Llc is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Shopko Stores Operating Co. Llc
5800 S Redwood Rd,
Salt Lake City, UT 84123-5327
Ph: (801) 964-1300 | Shopko Stores Operating Co. Llc
5800 S Redwood Rd,
Salt Lake City, UT 84123-5327
Ph: (801) 964-1300 |
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