Shopko Optical 4253 is a
Eyewear Supplier based in Faribault, Minnesota. Shopko Optical 4253 is licensed to practice in * (Not Available) (license number ) and their current practice location is
300 Western Ave Nw Ste 100 1/2, Faribault, Minnesota. It can be reached at their office (for appointments etc.) via phone at
(920) 429-2211.
NPI number for Shopko Optical 4253 is 1790459063 and their current mailing address is Po Box 19060, Green Bay, Wisconsin. Shopko Optical 4253
does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1790459063.
Healthcare Provider's Profile
| Full Name | Shopko Optical 4253 |
|---|
| Type | Facility |
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| Speciality | Eyewear Supplier |
|---|
| Location | 300 Western Ave Nw Ste 100 1/2, Faribault, Minnesota |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1790459063
- Provider Enumeration Date: 08/02/2021
- Last Update Date: 11/29/2024
Medical Identifiers
Medical identifiers for Shopko Optical 4253 such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1790459063 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 152W00000X | Optometrist | (* (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 Optical 4253 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 Optical 4253
Po Box 19060,
Green Bay, WI 54307-9060
Ph: (192) 042-9784 | Shopko Optical 4253
300 Western Ave Nw Ste 100 1/2,
Faribault, MN 55021-4528
Ph: (920) 429-2211 |
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