Shopko Stores Operating Co. LLC

NPI #1891747879 in Yakima, Washington

Provider Information

NPI Number
1891747879
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
5801 SUMMITVIEW AVE
City
Yakima
ZIP Code
98908-3006
Phone
(509) 965-6405

Authorized Official

Name
MICHAEL J BETTIGA, RPH
Title
SR. VICE PRESIDENT HEALTH SERVICES
Phone
(920) 429-4297

Specialties & Taxonomy Codes

Specialty
Optometrist
Technician/Technologist - OpticianOptician
Eyewear Supplier

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