Shoptikal LLC
Organization Active NPI Eyewear Supplier · Spokane, WA
NPI 1154987535 · NPPES record last updated Nov 29, 2024
Key facts
- NPI
- 1154987535
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Eyewear Supplier 332H00000X
- Legal business name
- SHOPTIKAL LLC
- Practice address
- 9326 N Division St
Spokane, WA 99218-1227 - Phone
- (509) 466-7136
- NPI assigned
- May 11, 2019
- Organization subpart
- No
Authorized official
- Name
- Russ Steinhorst
- Title
- Evp & Cfo
- Phone
- (920) 429-7842
Other NPIs on the same Medicare enrollment 2
Other NPIs with the same Medicare PAC ID 11
Corporate family (same tax ID) 2
Practitioners 215
-
Aaron James Cutler, O.D.
-
Tanya D Reid, O.D.
-
Jasdeep Sidhu, O.D.
-
Robert L Ulland, O.D.
-
Robert Keith Rudman, O.D.
-
Nicholas Barlas, OD
-
Bryce Boente, OD
-
Jennifer Lee Caine, O. D.
-
Jamie Lynn Elmore, O.D.
-
Alicja Janina Fitzgerald, O.D.
-
Deanne Kay Funkhouser, O.D.
-
Courtney Handzel, OD
-
Joshua Harshman, OD
-
Joseph Allen Herba, O.D.
-
Jake Jochimsen, OD
-
Krista Kay King, O.D.
-
Colleen Nicole Konkel, O.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190708001493 | WA | Part B Supplier - Clinic/Group Practice | 1456684471 |
Receives reassigned benefits from 5 practitioners 2 other NPIs on this enrollment Practice locations: Spokane, WA; Union Gap, WA; Wenatchee, WA |
National Provider Directory
- Tax ID family
- Shoptikal LLC
Locations
9326 N Division St
Spokane, WA 99218
Phone (509) 466-7136
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | |||
| Eyewear Supplier | 332H00000X | Yes |
Addresses
Primary practice location
9326 N Division St
Spokane, WA 99218-1227
Mailing address
PO Box 19060
Green Bay, WI 54307-9060
Other names
- Shopko Optical 4066
Other providers in Spokane, WA
- Megan Shope
- Shopko Stores Operating Co LLC
- Shopko Stores Operating Co LLC
- Shopko Stores Operating Co. LLC
- Shopko Stores Operating Co. LLC
- Shoquist DMD PLLC
- Misty D Shores
- Christopher Michael Shors
- Cydney Short
- Devin Short
All providers in Spokane, WA · Eyewear Supplier in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 29, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.