Shopko Stores Operating Co LLC

NPI #1689835647 in North Branch, Minnesota

Provider Information

NPI Number: 1689835647
Entity Type: Organization
Organization Name: Shopko Stores Operating Co LLC
Primary Specialty: Eyewear Supplier
Enumeration Date: Jun 23, 2008
Last Updated: Jun 18, 2009

Practice Location

Address: 5630 ST CROIX TRAIL
City: North Branch
State: Minnesota
ZIP Code: 55056
Phone: (651) 674-9951

Authorized Official

Name: MR. MICHAEL 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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