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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