Shopko Stores Operating Co. LLC
NPI #1033161419 in Lacey, Washington
Provider Information
- NPI Number
- 1033161419
- Entity Type
- Organization
- Organization Name
- Shopko Stores Operating Co. LLC
- Primary Specialty
- Eyewear Supplier
- Enumeration Date
- May 16, 2006
- Last Updated
- Jun 5, 2009
Practice Location
- Address
- 5500 MARTIN WAY E
- City
- Lacey
- State
- Washington
- ZIP Code
- 98516-6326
- Phone
- (360) 456-4532
Authorized Official
- Name
- MICHAEL J BETTIGA, RPH
- Title
- SR. VICE PRESIDENT HEALTH SERVICES
- Phone
- (920) 429-4297
Specialties & Taxonomy Codes
| Specialty |
|---|
| Optometrist |
| Technician/Technologist - Optician — Optician |
| Eyewear Supplier |
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