SHOPKO STORES OPERATING CO. LLC NPI 1003869678

NPI Information

SHOPKO STORES OPERATING CO. LLC is an eyewear supplier in Lewiston, ID. The provider is an organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. SHOPKO STORES OPERATING CO. LLC NPI is 1003869678. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Shopko Optical 072.

The provider's business location address is:

2120 THAIN GRADE
LEWISTON, ID
ZIP 83501-105
Phone: (208) 746-1050

The provider's authorized official is Michael J Bettiga .
The authorized official title is Sr. Vice President Health Services and has the following contact phone number (920) 429-4297.

The enumeration date for this NPI number is 5/18/2006 and was last updated on 8/3/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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