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Organization
SHOPKO STORES OPERATING CO LLC
Active
Organization
SHOPKO STORES OPERATING CO LLC
Active
Other names
SHOPKO OPTICAL
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL BETTIGA RPH (EXECUTIVE VICE PRESIDENT AND COO)
(920) 429-4297
Entity
Organization
Contact information
Practice address
3225 10TH ST E, GLENCOE, MN 55336-3369
(320) 864-5194
Mailing address
3225 10TH ST E, GLENCOE, MN 55336-3369
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
03/29/2013
Last updated
03/29/2013
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