Shopko Stores Operating Co LLC

NPI #1821343401 in Columbus, Wisconsin

Provider Information

NPI Number
1821343401
Entity Type
Organization
Organization Name
Shopko Stores Operating Co LLC
Primary Specialty
Eyewear Supplier
Enumeration Date
Jul 19, 2012
Last Updated
Jul 27, 2012

Practice Location

Address
200 COMMERCE DR
ZIP Code
53925
Phone
(920) 429-7137

Authorized Official

Name
MICHAEL BETTIGA, RPH
Title
EXECUTIVE VICE PRESIDENT AND COO
Phone
(920) 429-4297

Specialties & Taxonomy Codes

Specialty
Eyewear Supplier

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