Organization
SHOPKO STORES OPERATING CO. LLC
Active
Other names
ShopKo Optical 101
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL J BETTIGA RPH (SR. VICE PRESIDENT HEALTH SERVICES)
(920) 429-4297
Entity
Organization
Contact information
Practice address
4501 E ARROWHEAD PKWY, SIOUX FALLS, SD 57110-2701
(605) 335-8831
Mailing address
4501 E ARROWHEAD PKWY, SIOUX FALLS, SD 57110-2701
(605) 335-8831
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
014101
VIP
—
01
—
17915
MEDICARE
—
01
—
30673
AVESIS
—
01
—
CP2230-39
EYEMED
—
Enumeration date
05/19/2006
Last updated
02/11/2008
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us