Shopko Stores Operating Co. LLC
NPI #1174575500 in Saint Cloud, Minnesota
Provider Information
- NPI Number
- 1174575500
- Entity Type
- Organization
- Organization Name
- Shopko Stores Operating Co. LLC
- Primary Specialty
- Eyewear Supplier
- Enumeration Date
- May 16, 2006
- Last Updated
- Apr 15, 2008
Practice Location
- Address
- 4161 2ND ST S
- City
- Saint Cloud
- State
- Minnesota
- ZIP Code
- 56301-3761
- Phone
- (320) 253-5994
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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