Organization
SHOPKO STORES OPERATING CO. LLC
Active
Other names
ShopKo Optical 048
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
2005 KRENZIEN DR, NORFOLK, NE 68701-4601
(402) 379-1434
Mailing address
2005 KRENZIEN DR, NORFOLK, NE 68701-4601
(402) 379-1434
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007126
BLOCK
—
01
—
014048
VIP
—
01
—
094813
MEDICARE
—
01
—
17888
MEDICARE
—
01
—
35864
DAVIS
—
05
—
41098505421
—
NE
01
—
CP2230-28
EYEMED
—
Enumeration date
05/16/2006
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