SHOPKO OPTICAL 4130 (SHOPTIKAL LLC) NPI 1306402797

Eyewear Supplier in River Falls, WI

NPI 1306402797 Organization Eyewear Supplier

About SHOPKO OPTICAL 4130 (SHOPTIKAL LLC)

Shopko Optical 4130 (shoptikal Llc) is a provider established in River Falls, Wisconsin specializing in eyewear supplier. The NPI number of Shopko Optical 4130 (shoptikal Llc) is 1306402797 and was assigned on May 2019. The practitioner's primary taxonomy code is 332H00000X. The provider is registered as an organization and their NPI record was last updated 2 years ago. The provider's is doing business as Shopko Optical 4130. The authorized official of this NPI record is Russell Steinhorst (Ceo)

NPI

1306402797

Provider NameSHOPKO OPTICAL 4130 (SHOPTIKAL LLC)
Provider Location Address1674 COMMERCE CT RIVER FALLS, WI 54022
Provider Mailing AddressPO BOX 19060 GREEN BAY, WI 54307
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Other Organization NameSHOPKO OPTICAL 4130
Other Name TypeDoing Business As (3)
Enumeration Date05-12-2019
Last Update Date12-16-2019


Primary Taxonomy

Taxonomy Code332H00000X
ClassificationEyewear Supplier
TypeSuppliers
Taxonomy DescriptionAn organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.

Business Address

SHOPKO OPTICAL 4130
1674 COMMERCE CT
RIVER FALLS, WI
ZIP 54022
Phone: (715) 425-6144

Get Directions


Mailing Address

SHOPKO OPTICAL 4130
PO BOX 19060
GREEN BAY, WI
ZIP 54307
Phone:



Authorized Official

Authorized Official Name RUSSELL STEINHORST
Authorized Official TitleCEO
Authorized Official Phone(920) 429-7489

Other Providers at the same location


The following 3 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1285936393MCCLELLAND CHIROPRACTIC AND WELLNESS
Organization
Chiropractor1674 COMMERCE CT
RIVER FALLS, WI 54022
(715) 425-9439
1679980015GARTZKE CHIROPRACTIC INC.
Organization
Chiropractor1674 COMMERCE CT
RIVER FALLS, WI 54022
(715) 425-9439
1023294170 STEPHEN M GARTZKE
Individual
Chiropractor1674 COMMERCE CT
RIVER FALLS, WI 54022
(715) 425-9439

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.