Shopko Optical 113 is a
Eyewear Supplier based in Lacey, Washington. Shopko Optical 113 is licensed to practice in * (Not Available) (license number ) and their current practice location is
5500 Martin Way E, Lacey, Washington. It can be reached at their office (for appointments etc.) via phone at
(360) 456-4532.
NPI number for Shopko Optical 113 is 1033161419 and their current mailing address is 5500 Martin Way E, Lacey, Washington. Shopko Optical 113
does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1033161419.
Healthcare Provider's Profile
| Full Name | Shopko Optical 113 |
|---|
| Type | Facility |
|---|
| Speciality | Eyewear Supplier |
|---|
| Location | 5500 Martin Way E, Lacey, Washington |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1033161419
- Provider Enumeration Date: 05/16/2006
- Last Update Date: 06/05/2009
Medical Identifiers
Medical identifiers for Shopko Optical 113 such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1033161419 | NPI | - | NPPES |
| 17676 | Other | | MEDICARE |
| CP2230-57 | Other | | EYEMED |
| 2020667 | Medicaid | WA | |
| WA09205 | Other | WA | NORIDIAN SUBMITTER ID |
| 014113 | Other | | VIP |
| G8855125 | Other | | MEDICARE |
| 2016293 | Medicaid | WA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 152W00000X | Optometrist | (* (Not Available)) | Secondary |
| 156FX1800X | Technician/technologist - Optician | (* (Not Available)) | Secondary |
| 332H00000X | Eyewear Supplier | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Shopko Optical 113 is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Shopko Optical 113
5500 Martin Way E,
Lacey, WA 98516-6326
Ph: (360) 456-4532 | Shopko Optical 113
5500 Martin Way E,
Lacey, WA 98516-6326
Ph: (360) 456-4532 |
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