Shopko Stores Operating Co. LLC
NPI #1013960723 in Fond Du Lac, Wisconsin
Provider Information
- NPI Number
- 1013960723
- Entity Type
- Organization
- Organization Name
- Shopko Stores Operating Co. LLC
- Primary Specialty
- Eyewear Supplier
- Enumeration Date
- May 17, 2006
- Last Updated
- Feb 11, 2008
Practice Location
- Address
- 616 W JOHNSON ST
- City
- Fond Du Lac
- State
- Wisconsin
- ZIP Code
- 54935-3134
- Phone
- (920) 921-8290
Authorized Official
- Name
- MICHAEL J BETTIGA, RPH
- Title
- SR. VICE PRESIDENT HEALTH SERVICES
- Phone
- (920) 429-4297
Specialties & Taxonomy Codes
| Specialty |
|---|
| Eyewear Supplier |
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