Shopko Stores Operating Co. LLC

NPI #1871545996 in Worthington, Minnesota

Provider Information

NPI Number: 1871545996
Entity Type: Organization
Organization Name: Shopko Stores Operating Co. LLC
Primary Specialty: Eyewear Supplier
Enumeration Date: May 17, 2006
Last Updated: Apr 15, 2008

Practice Location

Address: 1755 N HUMISTON AVE
City: Worthington
State: Minnesota
ZIP Code: 56187-1757
Phone: (507) 372-7811

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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