| Shopko Stores Operating Company | |
|
2430 E Mason St, Green Bay, WI 54302-3759 | |
| (920) 468-4642 | |
| (920) 468-3490 |
| Full Name | Shopko Stores Operating Company |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 2430 E Mason St, Green Bay, Wisconsin |
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962452052 | NPI | - | NPPES |
| 38403100 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 1643-035 (Wisconsin) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Shopko Stores Operating Company 2430 E Mason St, Green Bay, WI 54302-3759 Ph: (920) 468-4642 | Shopko Stores Operating Company 2430 E Mason St, Green Bay, WI 54302-3759 Ph: (920) 468-4642 |
Brad J Lavallie, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 2253 W Mason St, Green Bay, WI 54303 Phone: 920-327-7000 Fax: 920-327-7005 | |
Gregory N Hubertus, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 550 N Military Ave, Ste 10, Green Bay, WI 54303 Phone: 920-498-2020 Fax: 920-498-2269 | |
April Kathleen Swim, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 2793 Lineville Rd, Green Bay, WI 54313 Phone: 920-496-4700 Fax: 920-496-4705 | |
Dr. Michelle Marie Mueller, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 216 S Military Ave, Green Bay, WI 54303 Phone: 920-494-3384 | |
Dr. James Leigh Elm, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 2811 S Oneida St, Green Bay, WI 54304 Phone: 920-496-9699 Fax: 920-496-1540 | |
Paye Eye Care Center Sc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 1515 Sixth St, Green Bay, WI 54304 Phone: 920-499-2147 Fax: 920-499-0574 | |
Teresa Elm, Optometrist Medicare: Medicare Enrolled Practice Location: 2811 S Oneida St, Green Bay, WI 54304 Phone: 920-496-9699 Fax: 920-496-1540 |