Organization
SHOPKO STORES OPERATING CO. LLC
Active
Other names
ShopKo Optical 141
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
313 N ROOSEVELT AVE, BURLINGTON, IA 52601-1757
(319) 758-9145
Mailing address
313 N ROOSEVELT AVE, BURLINGTON, IA 52601-1757
(319) 758-9145
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
014141
VIP
—
01
—
17698
MEDICARE
—
01
—
35436
AVESIS
—
01
—
CP2521-1
EYEMED
—
01
—
I3516
MEDICARE
—
Enumeration date
05/18/2006
Last updated
01/30/2008
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