Shopko Stores Operating Co LLC

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

Legal business name

SHOPKO STORES OPERATING CO LLC

Doing business as

Shopko Eyecare Center 4218

Practice address

1810 Jackson St
Oshkosh, WI 54901-2204

Phone

(920) 429-2211

NPI assigned

Sep 13, 2018

Last updated

Sep 13, 2018By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dilip Sedani

Title

VP

Phone

(920) 429-7688

Specialties & licenses 1

Addresses

Other names 1

• Shopko Eyecare Center 4218 Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1536796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536796800000",
    "number": "1871076968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 PILGRIM WAY",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543045263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 JACKSON ST",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549012204",
            "telephone_number": "920-429-2211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHOPKO STORES OPERATING CO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-13",
        "last_updated": "2018-09-13",
        "status": "A",
        "authorized_official_last_name": "SEDANI",
        "authorized_official_first_name": "DILIP",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "920-429-7688"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shopko Eyecare Center 4218",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Julie A Sheehan, DO
• Chandra Shekar, MD
• Alexey Shereshevsky, M.D.
• Stephanie Nicole Shoemaker Korb, PT
• Stephen L Shopbell, MD
• Shopko Stores Operating Co LLC (ShopKo Pharmacy 042)
• Shopko Stores Operating Co. LLC (ShopKo Optical 042)
• Shoptikal LLC (Shopko Optical 4218)
• Shoptikal LLC (Shopko Optical 4042)
• Ashley M Shoquist, P.A.

• Eyewear Supplier in Oshkosh, WI
• Providers in Oshkosh, WI by specialty
• Eyewear Supplier in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.