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Shopko Stores Operating Co. LLC — NPI 1174576748, Missoula, MT | NPI Central

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NPI 1174576748

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Shopko Stores Operating Co. LLC

NPI 1174576748 · Eyewear Supplier · Missoula, MT

Provider details

NPI number: 1174576748
Entity type: Organization
Primary specialty: Eyewear SupplierSuppliers
Organization subpart: No
Authorized official: Michael Bettiga, Sr. Vice President Health Services(920) 429-4297

Specialties & taxonomies

Eyewear SupplierPrimary332H00000X
Suppliers
Optician156FX1800X
Eye and Vision Services Providers
Optometrist152W00000X
Eye and Vision Services Providers

Practice location

2510 S Reserve St

Missoula, MT 59801-7546

Phone: (406) 721-4646

Approximate (ZIP-level) locationGet directions

More MT providers

Mailing address

2510 S Reserve St

Missoula, MT 59801-7546

Other names (DBA / former)

Doing business as: Shopko Optical 075

Registry dates

Enumerated: 2006-05-18
Last updated: 2008-04-24

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.