Shopko Stores Operating Co. LLC

NPI #1750334181 in Mitchell, South Dakota

Provider Information

NPI Number: 1750334181
Entity Type: Organization
Organization Name: Shopko Stores Operating Co. LLC
Primary Specialty: Eyewear Supplier
Enumeration Date: May 18, 2006
Last Updated: Feb 11, 2008

Practice Location

Address: 1900 N MAIN ST
City: Mitchell
State: South Dakota
ZIP Code: 57301-1160
Phone: (605) 996-7042

Authorized Official

Name: MICHAEL J 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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