Provider Demographics
NPI:1639391279
Name:DR. RICHARD E. HULTS & ASSOC., INC
Entity Type:Organization
Organization Name:DR. RICHARD E. HULTS & ASSOC., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:E
Authorized Official - Last Name:HULTS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:330-963-3939
Mailing Address - Street 1:PO BOX 880
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:OH
Mailing Address - Zip Code:44236-5880
Mailing Address - Country:US
Mailing Address - Phone:330-963-3939
Mailing Address - Fax:866-425-2239
Practice Address - Street 1:691 RICHMOND RD.
Practice Address - Street 2:
Practice Address - City:RICHMOND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44143
Practice Address - Country:US
Practice Address - Phone:440-442-4930
Practice Address - Fax:866-425-2239
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2010-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3420152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHRI9274044Medicare ID - Type Unspecified