NPI | 1881645190 |
---|---|
Doing Business As | SHOPKO OPTICAL 098 |
Entity Type | Organization |
Authorized Contact | MICHAEL J BETTIGA Sr. Vice President Health Services 920-429-4297 |
Organization Subpart ? | No |
Primary Taxonomy | 332H00000X Eyewear Supplier |
Enumeration Date | 2006-05-12 |
Last Update Date | 2008-07-10 |