Shopko Optical 4084 – Eyewear Supplier, NPI 1407412885
Eyewear Supplier
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Shopko Optical 4084
1520 W 9000 S STE E
WEST JORDAN, UT 840888001
Phone: (801) 561-7300
Type: Location
PO box, Russell Road, Paoli, Tredyffrin Township, Chester County, Pennsylvania, 19301, United States
GREEN BAY, WI 543079060
Phone:
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2019-06-27
PECOS data refreshed: 2026-05-27
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 84088)
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