Healthcare Provider Details

I. General information

NPI: 1295913002
Provider Name (Legal Business Name): HR OPTICAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2008
Last Update Date: 05/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

246 POPLAR AVE STE 1
SOMERSET KY
42503-1701
US

IV. Provider business mailing address

246 POPLAR AVE SUITE 1
SOMERSET KY
42503-1701
US

V. Phone/Fax

Practice location:
  • Phone: 606-679-8469
  • Fax: 606-678-8891
Mailing address:
  • Phone: 606-679-8469
  • Fax: 606-678-8891

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number929
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: SHEILA K REYNOLDS
Title or Position: OPTICIAN
Credential:
Phone: 606-679-8469