SHOPKO STORES OPERATING CO LLC NPI 1790736023

NPI Information

SHOPKO STORES OPERATING CO LLC is an eyewear supplier in Salem, OR. 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 1790736023. The provider is registered as an organization entity type.
The provider Is Doing Business As Shopko Optical 111.

The provider's business location address is:

1230 LANCASTER DR SE
SALEM, OR
ZIP 97317-800
Phone: (503) 371-6575

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 5/12/2006 and was last updated on 11/20/2008.

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:

Other Identifiers

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