| NPI | 1134785512 | 
|---|---|
| Doing Business As | SHOPKO OPTICAL 4088 | 
| Entity Type | Organization | 
| Authorized Contact | RUSSELL STEINHORST EVP & CFO 920-429-7489 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) | 
| Additional Taxonomies | 152W00000X Optometrist | 
| Enumeration Date | 2019-05-11 | 
| Last Update Date | 2024-11-29 |