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: July 19, 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
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

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.

Pharmacy (Community/Retail Pharmacy)
3200 BROADWAY ST
QUINCY, IL 62301
General Practice
3200 BROADWAY ST
QUINCY, IL 62301
Nurse Practitioner
3200 BROADWAY ST
QUINCY, IL 62301

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1649222662, enumerated as an "organization" on May 17, 2006.

The provider is located at 3200 BROADWAY ST QUINCY, IL 62301 and the phone number is (217) 224-0993.

Eyewear Supplier with taxonomy code 332H00000X.

The provider might be accepting Accepts: Medicare, Medicaid and Blue Cross Blue Shield. Please consult your insurance carrier or call the provider to verify.