SHOPKO OPTICAL 4229 – NPI #1801493903
Eyewear Supplier

An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.

SHOPKO OPTICAL 4229 is an eyewear supplier located in CHAMPLIN, MN. NPPES has assigned the NPI number 1801493903 to SHOPKO OPTICAL 4229 on October 02, 2020. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “SHOPKO OPTICAL 4229” is a dba name, the actual legal business name for this organization is SHOPTIKAL LLC. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 332H00000X from the Health Care Provider Taxonomy code set, which is classified as Eyewear Supplier.

The NPI profile was last updated on Nov 29, 2024. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for SHOPKO OPTICAL 4229 below.

NPI Profile for
SHOPTIKAL LLC

NPI Number
1801493903
Enumeration Date

(more than 5 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
SHOPTIKAL LLC
Doing Business As (dba): SHOPKO OPTICAL 4229
Primary location
11995 BUSINESS PARK BLVD N
CHAMPLIN, MN 55316
Phone: (763) 343-5937 Fax:
Mailing address
PO BOX 19060
GREEN BAY, WI 54307-9060
Phone: (920) 429-7842 Fax:
Organization Subpart
No
Authorized Official
RUSSELL STEINHORST
EVP & CFO
Phone: (920) 429-7489
Updated
Certification Date
Nov 29, 2024

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
332H00000X
- Eyewear Supplier (Primary)
152W00000X
- Optometrist

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.