MEDICARE: RX OPTICAL LABORATORIES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist

General Provider Information

NPI Number	:	1407913288
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RX OPTICAL LABORATORIES, INC.

Provider Business Mailing Address
First Line	:	1825 S PARK ST
Second Line	:
City	:	KALAMAZOO
State	:	MI
Zip	:	49001-2759
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1761 S M-139
Second Line	:
City	:	BENTON HARBOR
State	:	MI
Zip	:	49023-6101
Country	:	US
Telephone Number	:	269-934-0424
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	STEPHAN JEPSON
Credential	:
Telephone Number	:	269-342-0003

Provider Enumeration Date	:	01/02/2007
Last Update Date	:	12/11/2017

Similar Medicare Providers

1497893267 — MR. STEVEN EDWARD WOLTER R. PH.
Practice Location Address:

1485 SOUTH M-139
BENTON HARBOR, MI
49023-0547

Practice Phone: 269-934-0119
Practice Fax:

1447402631 — MS. LISA R COLE LMSW, ACSW
Practice Location Address:

960 AGARD AVE
BENTON HARBOR, MI
49023-0751

Practice Phone: 269-944-1747
Practice Fax: 269-944-5535

1821429390 — MARIESA TINKHAM LLMSW
Practice Location Address:

1485 S M-139
BENTON HARBOR, MI
49023

Practice Phone: 269-925-0585
Practice Fax: 269-927-1326

1326424821 — ALICIA SAUERS
Practice Location Address:

1485 S. M-139 , NONE
BENTON HARBOR, MI
49023

Practice Phone: 269-934-3467
Practice Fax:

1811065469 — DR. DIANA L HASKINS O.D.
Practice Location Address:

1761 M 139
BENTON HARBOR, MI
49022-6101

Practice Phone: 269-934-0424
Practice Fax: 269-934-0570

1942453972 — ABDELWAHAD BENDAMKILA
Practice Location Address:

1701 M 139
BENTON HARBOR, MI
49022-6101

Practice Phone: 269-823-4801
Practice Fax:

Directions to “RX OPTICAL LABORATORIES, INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.