NPI 1003869678

Shopko Stores Operating Co. LLC

Organisation Eyewear Supplier Lewiston, ID

Practice location

Address: 2120 Thain Grade, Lewiston, ID 83501-4105
Phone: (208) 746-1050

Authorised official

Name: Michael J Bettiga
Title: Sr. Vice President Health Services
Phone: (920) 429-4297

Registered specialties (2)

Eyewear Supplier Primary

Suppliers Taxonomy 332H00000X

Other Eyewear Supplier providers in Idaho →

Optician

Eye and Vision Services Providers Taxonomy 156FX1800X

Other Technician/Technologist providers in Idaho →

Registry record

NPI: 1003869678
Entity type: Organization
NPI issued: 18 May 2006
Record last updated: 3 Aug 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.