Shopko Stores Operating Co. LLC

NPI #1073565123 in Spokane Valley, Washington

Provider Information

NPI Number
1073565123
Entity Type
Organization
Organization Name
Shopko Stores Operating Co. LLC
Primary Specialty
Eyewear Supplier
Enumeration Date
May 17, 2006
Last Updated
Jun 5, 2009

Practice Location

Address
13414 E SPRAGUE AVE
ZIP Code
99216-0848
Phone
(509) 924-2015

Authorized Official

Name
MICHAEL J BETTIGA, RPH
Title
SR. VICE PRESIDENT HEALTH SERVICES
Phone
(920) 429-4297

Specialties & Taxonomy Codes

Specialty
Optometrist
Technician/Technologist - OpticianOptician
Eyewear Supplier

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