Shopko Stores Operating Co. LLC

NPI #1386696383 in Wenatchee, Washington

Provider Information

NPI Number: 1386696383
Entity Type: Organization
Organization Name: Shopko Stores Operating Co. LLC
Primary Specialty: Eyewear Supplier
Enumeration Date: May 17, 2006
Last Updated: Jun 5, 2009

Practice Location

Address: 1340 N WENATCHEE AVE
City: Wenatchee
State: Washington
ZIP Code: 98801-1558
Phone: (509) 663-8868

Authorized Official

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

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X
Technician/Technologist - Optician — Optician	156FX1800X
Eyewear Supplier	332H00000X	Primary

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