Provider Demographics
NPI:1447242524
Name:R D OPTICAL CO
Entity Type:Organization
Organization Name:R D OPTICAL CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:D'APOLITO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:330-856-6873
Mailing Address - Street 1:3921 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-4711
Mailing Address - Country:US
Mailing Address - Phone:330-856-6873
Mailing Address - Fax:330-856-4539
Practice Address - Street 1:3921 E MARKET ST
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-4711
Practice Address - Country:US
Practice Address - Phone:330-856-6873
Practice Address - Fax:330-856-4539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-16
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH78 044188332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000206395OtherANTHEM SENIOR ADVANTAGE
OH0952483Medicaid
OH0485890001Medicare NSC