Organization · NPI-2
Shoptikal LLC
Eyewear Supplier (Equipment, not the service) · Shawano, WI
NPI number1841058286
StatusActive
Last updated in NPPESNov 29, 2024
Details
- NPI
- 1841058286
- Entity type
- Organization (NPI-2)
- Legal business name
- Shoptikal LLC
- Organization subpart
- No
- Enumeration date
- Mar 11, 2024
- Certification date
- Nov 29, 2024
- Last updated
- Nov 29, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 332H00000X | Eyewear Supplier (Equipment, not the service) | – | – | Yes |
| 152W00000X | Optometrist | – | – |
Other names
- Shopko Optical 4304 (Doing Business As)
Practice location
1056 E Green Bay St Ste 500Shawano, WI 54166-2296
Phone 920-429-2211
Mailing address
Po Box 19060Green Bay, WI 54307-9060
Phone 920-429-7285
Authorized official
Russell Steinhorst
Evp & Cfo
9204297489
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