NPI | 1750036083 |
---|---|
Doing Business As | SHOPKO OPTICAL 4264 |
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 | 2022-02-15 |
Last Update Date | 2024-11-29 |