Shopko Stores Operating Co. LLC
Eyewear Supplier (Equipment, not the service) in Wenatchee, WA. Organization (NPI-2).
NPI number1386696383
StatusActive
Last updated in NPPESJun 5, 2009
Details
- NPI
- 1386696383
- Entity type
- Organization (NPI-2)
- Legal business name
- Shopko Stores Operating Co. LLC
- Organization subpart
- No
- Enumeration date
- May 17, 2006
- Last updated
- Jun 5, 2009
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 332H00000X | Eyewear Supplier (Equipment, not the service) | – | – | Yes |
| 152W00000X | Optometrist | – | – | |
| 156FX1800X | Technician/Technologist, Optician | – | – |
Other names
- Shopko Optical 122 (Doing Business As)
Practice location
1340 N Wenatchee AveWenatchee, WA 98801-1558
Phone 509-663-8868
Mailing address
1340 N Wenatchee AveWenatchee, WA 98801-1558
Phone 509-663-8868
Authorized official
Michael J Bettiga
Sr. Vice President Health Services
9204294297
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