Shopko Stores Operating Co. LLC

NPI #1164474698 in Grand Island, Nebraska

Provider Information

NPI Number: 1164474698
Entity Type: Organization
Organization Name: Shopko Stores Operating Co. LLC
Primary Specialty: Eyewear Supplier
Enumeration Date: May 16, 2006
Last Updated: Feb 11, 2008

Practice Location

Address: 2208 N WEBB RD
City: Grand Island
State: Nebraska
ZIP Code: 68803-1739
Phone: (308) 382-7661

Authorized Official

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

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Eyewear Supplier	332H00000X	Primary

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