NPI 1174575500

Shopko Stores Operating Co. LLC

Organisation Eyewear Supplier Saint Cloud, MN

Practice location

Address: 4161 2nd St S, Saint Cloud, MN 56301-3761
Phone: (320) 253-5994

Authorised official

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

Registered specialties

Eyewear Supplier Primary

Suppliers Taxonomy 332H00000X

Other Eyewear Supplier providers in Minnesota →

Registry record

NPI: 1174575500
Entity type: Organization
NPI issued: 16 May 2006
Record last updated: 15 Apr 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.