Shopko Stores Operating Co. LLC
NPI #1114970985 in Spanish Fork, Utah
Provider Information
- NPI Number
- 1114970985
- Entity Type
- Organization
- Organization Name
- Shopko Stores Operating Co. LLC
- Primary Specialty
- Eyewear Supplier
- Enumeration Date
- May 19, 2006
- Last Updated
- Jul 10, 2008
Practice Location
- Address
- 955 N MAIN ST
- City
- Spanish Fork
- State
- Utah
- ZIP Code
- 84660-1150
- Phone
- (801) 798-3557
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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