| Shoptikal Llc | |
|
738 Kirkwood Mall, Bismarck, ND 58504-5753 | |
| (701) 258-8810 | |
| Not Available |
| Full Name | Shoptikal Llc |
|---|---|
| Type | Facility |
| Speciality | Eyewear Supplier |
| Location | 738 Kirkwood Mall, Bismarck, North Dakota |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518601483 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | (* (Not Available)) | Secondary |
| 332H00000X | Eyewear Supplier | (* (Not Available)) | Primary |
| Provider Name | Wendy Lawson Kopp |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1669581765 PECOS PAC ID: 6507858503 Enrollment ID: I20040401000428 |
| Provider Name | James B Connelly |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1508884016 PECOS PAC ID: 2769474311 Enrollment ID: I20040417000448 |
| Provider Name | Shanon G Bencker |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1972612075 PECOS PAC ID: 2264482835 Enrollment ID: I20050201000136 |
| Provider Name | Shari L Kensok |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1366548752 PECOS PAC ID: 3971556085 Enrollment ID: I20050301000778 |
| Provider Name | Carissa Guler |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1386028777 PECOS PAC ID: 6305153321 Enrollment ID: I20150923001233 |
| Provider Name | Vanessa R Manlove |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1376194472 PECOS PAC ID: 1951735125 Enrollment ID: I20191220001079 |
| Mailing Address | Practice Location Address |
|---|---|
| Shoptikal Llc Po Box 19060, Green Bay, WI 54307-9060 Ph: (920) 429-7285 | Shoptikal Llc 738 Kirkwood Mall, Bismarck, ND 58504-5753 Ph: (701) 258-8810 |