Organization
SHOPKO STORES OPERATING CO. LLC
Active
Other names
ShopKo Optical 034
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
2602 SHOPKO DR, MADISON, WI 53704-4074
(608) 249-6967
Mailing address
2602 SHOPKO DR, MADISON, WI 53704-4074
(608) 249-6967
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
014034
VIP
—
01
—
17651
MEDICARE
—
01
—
35573
AVESIS
—
05
—
38418400
—
WI
01
—
410985054-4034
NVA
—
01
—
42616
DAVIS
—
01
—
CP2230-77
EYEMED
—
Enumeration date
05/17/2006
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