Shopko Stores Operating Co. LLC

NPI #1750333803 in Racine, Wisconsin

Provider Information

NPI Number
1750333803
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
4801 WASHINGTON AVE
City
Racine
ZIP Code
53406-4219
Phone
(262) 637-3733

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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