| Shoptikal Llc | |
|
1919 N Diers Ave Ste B, Grand Island, NE 68803-1284 | |
| (308) 382-7661 | |
| Not Available |
| Full Name | Shoptikal Llc |
|---|---|
| Type | Facility |
| Speciality | Eyewear Supplier |
| Location | 1919 N Diers Ave Ste B, Grand Island, Nebraska |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952967325 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | (* (Not Available)) | Secondary |
| 332H00000X | Eyewear Supplier | (* (Not Available)) | Primary |
| Provider Name | Robert David Sanders |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1144273327 PECOS PAC ID: 1557329653 Enrollment ID: I20041221000445 |
| Provider Name | Anthony James Manthey |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1669423869 PECOS PAC ID: 1658339775 Enrollment ID: I20041221000601 |
| Provider Name | Russell D Smith |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1285687442 PECOS PAC ID: 7315905452 Enrollment ID: I20041221000741 |
| Provider Name | Gregory P Gerdes |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1497707244 PECOS PAC ID: 0840203782 Enrollment ID: I20060719000321 |
| Provider Name | Mark Jay Witte |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1699714964 PECOS PAC ID: 3577566785 Enrollment ID: I20060808000481 |
| Provider Name | Donald R Krysl |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1730118233 PECOS PAC ID: 1658374236 Enrollment ID: I20060821000556 |
| Provider Name | Jason L Hawley |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1235275983 PECOS PAC ID: 2567545346 Enrollment ID: I20080218000190 |
| Provider Name | Melinda K Kennel |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1013908656 PECOS PAC ID: 4486657905 Enrollment ID: I20080731000795 |
| Provider Name | Gregory J Bruening |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1811909476 PECOS PAC ID: 6901937572 Enrollment ID: I20100625000135 |
| Provider Name | Matthew S Porn |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1659752368 PECOS PAC ID: 5698045318 Enrollment ID: I20170727003037 |
| Provider Name | Zachery Baumfalk |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1871002170 PECOS PAC ID: 5698021707 Enrollment ID: I20180703001575 |
| Provider Name | Seth Lambert |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1336459312 PECOS PAC ID: 9830500461 Enrollment ID: I20201202002663 |
| Provider Name | Stephanie D Dufner |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1518272798 PECOS PAC ID: 2769897511 Enrollment ID: I20210209001601 |
| Provider Name | Mary Elizabeth Boeckman |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1134791981 PECOS PAC ID: 3173926698 Enrollment ID: I20210721003055 |
| Provider Name | Chelsea Lynn Lula |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1023681467 PECOS PAC ID: 5193121630 Enrollment ID: I20210908001905 |
| Provider Name | Emily Weakland |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1265002521 PECOS PAC ID: 7810393147 Enrollment ID: I20210910001915 |
| Provider Name | Tracey Payne |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1922140748 PECOS PAC ID: 7214335900 Enrollment ID: I20211011001649 |
| Provider Name | Sadie Cole |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1578811493 PECOS PAC ID: 7315339876 Enrollment ID: I20220113002273 |
| Provider Name | Jacqueline Carmen Elizabeth Evans |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1053726315 PECOS PAC ID: 4587997473 Enrollment ID: I20220601002465 |
| Provider Name | Leann Goslak |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1205915451 PECOS PAC ID: 0840473484 Enrollment ID: I20220803001444 |
| Provider Name | Deanna Ippolito |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1225683121 PECOS PAC ID: 8426388257 Enrollment ID: I20221003001926 |
| Provider Name | Joel Robert Holmquist |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1013691484 PECOS PAC ID: 0840658019 Enrollment ID: I20230620002659 |
| Provider Name | Megan Kidd |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1417251471 PECOS PAC ID: 7012205727 Enrollment ID: I20231024000238 |
| Mailing Address | Practice Location Address |
|---|---|
| Shoptikal Llc Po Box 19060, Green Bay, WI 54307-9060 Ph: () - | Shoptikal Llc 1919 N Diers Ave Ste B, Grand Island, NE 68803-1284 Ph: (308) 382-7661 |