NPI 1114100518

Shopko Stores Operating Co LLC

Organisation Eyewear Supplier Appleton, WI

Practice location

Address: W3208 van Roy Rd, Appleton, WI 54915
Phone: (920) 111-1111

Authorised official

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

Registered specialties

Eyewear Supplier Primary

Suppliers Taxonomy 332H00000X

Other Eyewear Supplier providers in Wisconsin →

Registry record

NPI: 1114100518
Entity type: Organization
NPI issued: 10 Dec 2007
Record last updated: 17 Jul 2008

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.