Shopko Stores Operating Co. LLC

NPI #1932152501 in Kimberly, Wisconsin

Provider Information

NPI Number
1932152501
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
800 E MAES AVE
ZIP Code
54136-1527
Phone
(920) 788-4114

Authorized Official

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

Specialties & Taxonomy Codes

Specialty
Eyewear Supplier

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