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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
N2585 PLAZA RD, WAUTOMA, WI 54982-7706
(920) 787-7709
Mailing address
N2585 PLAZA RD, WAUTOMA, WI 54982-7706

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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