Shopko Stores Operating Co. LLC

NPI #1700838729 in Dixon, Illinois

Provider Information

NPI Number
1700838729
Entity Type
Organization
Organization Name
Shopko Stores Operating Co. LLC
Primary Specialty
Eyewear Supplier
Enumeration Date
May 17, 2006
Last Updated
Jun 4, 2008

Practice Location

Address
1350 N GALENA AVE
City
Dixon
ZIP Code
61021-1010
Phone
(815) 284-3935

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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