Shopko Stores Operating Co. LLC

NPI #1396798161 in Orem, Utah

Provider Information

NPI Number
1396798161
Entity Type
Organization
Organization Name
Shopko Stores Operating Co. LLC
Primary Specialty
Eyewear Supplier
Enumeration Date
May 19, 2006
Last Updated
Jul 10, 2008

Practice Location

Address
125 S STATE ST
City
Orem
State
Utah
ZIP Code
84058-5419
Phone
(801) 225-4700

Authorized Official

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

Specialties & Taxonomy Codes

Specialty
Optometrist
Technician/Technologist - OpticianOptician
Eyewear Supplier

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