Shopko Stores Operating Co. LLC

NPI #1649222522 in Marinette, Wisconsin

Provider Information

NPI Number
1649222522
Entity Type
Organization
Organization Name
Shopko Stores Operating Co. LLC
Primary Specialty
Eyewear Supplier
Enumeration Date
May 17, 2006
Last Updated
Feb 11, 2008

Practice Location

Address
2741 ROOSEVELT RD
ZIP Code
54143-3833
Phone
(715) 735-0260

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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