Shopko Stores Operating Co. LLC

NPI #1225088768 in Marquette, Michigan

Provider Information

NPI Number: 1225088768
Entity Type: Organization
Organization Name: Shopko Stores Operating Co. LLC
Primary Specialty: Eyewear Supplier
Enumeration Date: May 12, 2006
Last Updated: May 29, 2008

Practice Location

Address: 1150 W WASHINGTON ST
City: Marquette
State: Michigan
ZIP Code: 49855-4040
Phone: (906) 228-4120

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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