Healthcare Provider Details

I. General information

NPI: 1780720078
Provider Name (Legal Business Name): RRS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 03/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

181 E MAIN ST
GOUVERNEUR NY
13642-1552
US

IV. Provider business mailing address

PO BOX 326
GOUVERNEUR NY
13642-0326
US

V. Phone/Fax

Practice location:
  • Phone: 315-287-1344
  • Fax: 315-287-4419
Mailing address:
  • Phone: 315-287-1344
  • Fax: 315-287-4419

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number0003785
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number0003785
License Number StateNY

VIII. Authorized Official

Name: ROBERT NEEDLE SAIDEL
Title or Position: OWNER PRES
Credential: OD
Phone: 315-287-1344