SHOPKO STORES OPERATING CO LLC NPI 1942483342

NPI Information

SHOPKO STORES OPERATING CO LLC is an eyewear supplier in Green Bay, WI. 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 1942483342. The provider is registered as an organization entity type.
The provider Is Doing Business As Shopko Optical 177.

The provider's business location address is:

2320 LINEVILLE RD
GREEN BAY, WI
ZIP 54313-836
Phone: (920) 434-5845

The provider's authorized official is Michael 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 12/10/2007 and was last updated on 4/20/2008.

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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