Shopko Stores Operating Co. LLC
NPI #1801848924 in Pullman, Washington
Provider Information
- NPI Number
- 1801848924
- Entity Type
- Organization
- Organization Name
- Shopko Stores Operating Co. LLC
- Primary Specialty
- Eyewear Supplier
- Enumeration Date
- May 17, 2006
- Last Updated
- Jun 5, 2009
Practice Location
- Address
- 1450 S GRAND AVE
- City
- Pullman
- State
- Washington
- ZIP Code
- 99163-4900
- Phone
- (509) 332-0820
Authorized Official
- Name
- MICHAEL J BETTIGA, RPH
- Title
- SR. VICE PRESIDENT HEALTH SERVICES
- Phone
- (920) 429-4297
Specialties & Taxonomy Codes
| Specialty |
|---|
| Technician/Technologist - Optician — Optician |
| Optometrist |
| Eyewear Supplier |
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