Shopko Optical 075 in Missoula, MT - Eyewear Supplier

Shopko Optical 075 is a Eyewear Supplier based in Missoula, Montana. Shopko Optical 075 is licensed to practice in * (Not Available) (license number ) and their current practice location is 2510 S Reserve St, Missoula, Montana. It can be reached at their office (for appointments etc.) via phone at (406) 721-4646.

NPI number for Shopko Optical 075 is 1174576748 and their current mailing address is 2510 S Reserve St, Missoula, Montana. Shopko Optical 075 does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1174576748.

Contact Information

	Shopko Optical 075
	2510 S Reserve St, Missoula, MT 59801-7546
	(406) 721-4646
	Not Available

Healthcare Provider's Profile

Full Name	Shopko Optical 075
Type	Facility
Speciality	Eyewear Supplier
Location	2510 S Reserve St, Missoula, Montana
Accepts Medicare Assignments	Does not participate in Medicare Program. The facility may not accept medicare assignment.

NPI Data:

NPI Number: 1174576748
Provider Enumeration Date: 05/18/2006
Last Update Date: 04/24/2008

Medical Identifiers

Medical identifiers for Shopko Optical 075 such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1174576748	NPI	-	NPPES
0550862	Medicaid	MT
17878	Other		MEDICARE
35494	Other		AVESIS
213121-21	Other		EYEMED
014075	Other		VIP

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 075 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 075 2510 S Reserve St, Missoula, MT 59801-7546 Ph: (406) 721-4646	Shopko Optical 075 2510 S Reserve St, Missoula, MT 59801-7546 Ph: (406) 721-4646

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Shopko Optical 075 - in Missoula, MT