Shopko Stores Operating Co LLC

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

Legal business name

SHOPKO STORES OPERATING CO LLC

Doing business as

Shopko Optical

Practice address

211 S 23Rd St
Plattsmouth, NE 68048-2903

Phone

(402) 296-5252

NPI assigned

Mar 29, 2013

Organization subpart

No

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

Authorized official

Name

Russell Steinhorst

Title

SVP Chief Financial Officer

Phone

(920) 429-7489

Specialties & licenses 1

Addresses

Other names 1

• SHOPKO OPTICAL Doing business as

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

{
    "created_epoch": "1364515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457395200000",
    "number": "1972846863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 S 23RD ST",
            "city": "PLATTSMOUTH",
            "state": "NE",
            "postal_code": "680482903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 S 23RD ST",
            "city": "PLATTSMOUTH",
            "state": "NE",
            "postal_code": "680482903",
            "telephone_number": "402-296-5252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHOPKO STORES OPERATING CO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-29",
        "last_updated": "2016-03-08",
        "status": "A",
        "authorized_official_last_name": "STEINHORST",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_title_or_position": "SVP CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "920-429-7489"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SHOPKO OPTICAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Teresa Schram
• Hunter Graham Severin
• James Edward Shade II
• Melissa Shade
• Shopko Stores Operating Co LLC (Shopko Pharmacy 662)
• Tiffany Simon, RN
• Erin Gayle Smith, FNP-C
• Elisa Solis
• Aubry Reann Stark
• Rebecca Lee Steinke, LPN

• Eyewear Supplier in Plattsmouth, NE
• Providers in Plattsmouth, NE by specialty
• Eyewear Supplier in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2016; 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.