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SHOPKO OPTICAL 139
NPI 1649222662
Eyewear Supplier in Quincy, IL

Active since May 17, 2006
3200 BROADWAY ST, QUINCY, IL 62301(217) 224-0993 Get Directions Write a Review

NPPES record last updated: June 4, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Shopko Optical 139 NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHOPKO OPTICAL 139 (NPI 1649222662) is a healthcare organization registered as an eyewear supplier in Quincy, Illinois and active in the NPI registry since May 2006. The organization lists Michael J Bettiga, Sr. Vice President Health Services, as its authorized official.

NPPES Registry Identity

NPI1649222662
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameSHOPKO STORES OPERATING CO. LLC
Location Address3200 BROADWAY STQuincy, IL 62301-3712
Mailing Address3200 Broadway StQuincy, IL 62301-3712 · (217) 224-0993
Phone(217) 224-0993
Organization SubpartNo
Authorized OfficialMichael J BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateMay 17, 2006
Last NPPES UpdateJune 4, 2008
✔ NPI 1649222662 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEyewear SupplierSuppliers
Taxonomy Code332H00000X
Definition
An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.
3200 BROADWAY ST, Quincy, IL 62301
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Other Names 1

Doing Business AsShopko Optical 139

Other Identifiers 10

OtherCP2521-5Eyemed
Other5232016IL · Bcbs Il
Medicare PINDF0851
Other35459Avesis
Other42554Davis
Other17686Medicare
Medicare ID-Type Unspecified1249550008
Medicare NSC5695760132
Other014139Vip
Medicare PIN213638

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BLESSING HOSPITAL
General Practice
3200 BROADWAY ST
QUINCY, IL 62301
Adams County (217) 223-8400
SHOPKO STORES OPERATING CO LLC
Pharmacy (Community/Retail Pharmacy)
3200 BROADWAY ST
QUINCY, IL 62301
Adams County (217) 224-0776
KELLY J RIFE NP
Nurse Practitioner
3200 BROADWAY ST
QUINCY, IL 62301
Adams County (217) 223-8400

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shopko Stores Operating Co. LLC's NPI number?

The NPI number for Shopko Stores Operating Co. LLC is 1649222662. It was assigned to this organization in the NPPES registry on May 17, 2006. The provider is doing business as Shopko Optical 139.

Where is Shopko Stores Operating Co. LLC located?

Shopko Stores Operating Co. LLC is located at 3200 Broadway St, Quincy, IL 62301. The listed phone number is (217) 224-0993.

What is Shopko Stores Operating Co. LLC's specialty?

The primary specialty registered for this NPI is Eyewear Supplier with taxonomy code 332H00000X.

When was this NPI record last updated?

The NPPES record for Shopko Stores Operating Co. LLC was last updated on June 4, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.