Provider Demographics
NPI:1174652374
Name:RPM OPTICAL
Entity Type:Organization
Organization Name:RPM OPTICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOROFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:AXLINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-726-2446
Mailing Address - Street 1:4611 DONITHEN RD
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:OH
Mailing Address - Zip Code:43302-9158
Mailing Address - Country:US
Mailing Address - Phone:740-726-2446
Mailing Address - Fax:740-726-2446
Practice Address - Street 1:399 E CHURCH ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:OH
Practice Address - Zip Code:43302-4143
Practice Address - Country:US
Practice Address - Phone:740-726-2446
Practice Address - Fax:740-726-2446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty