NPI 1497708085

Shopko Stores Operating Co. LLC

Organisation Eyewear Supplier Coeur D Alene, ID

Practice location

Address: 217 W Ironwood Dr, Coeur D Alene, ID 83814-2651
Phone: (208) 765-8078

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: 1497708085
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.