Shopko Stores Operating Co. LLC

NPI #1174576748 in Missoula, Montana

Provider Information

NPI Number
1174576748
Entity Type
Organization
Organization Name
Shopko Stores Operating Co. LLC
Primary Specialty
Eyewear Supplier
Enumeration Date
May 18, 2006
Last Updated
Apr 24, 2008

Practice Location

Address
2510 S RESERVE ST
State
Montana
ZIP Code
59801-7546
Phone
(406) 721-4646

Authorized Official

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

Specialties & Taxonomy Codes

Specialty
Technician/Technologist - OpticianOptician
Optometrist
Eyewear Supplier

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