Provider Demographics
NPI:1790962025
Name:RMK HOLYOKE OPTICAL INC
Entity Type:Organization
Organization Name:RMK HOLYOKE OPTICAL INC
Other - Org Name:HOLYOKE OPTICIANS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:KULPINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:OPTICIAN
Authorized Official - Phone:413-536-7670
Mailing Address - Street 1:185 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:HOLYOKE
Mailing Address - State:MA
Mailing Address - Zip Code:01040-6504
Mailing Address - Country:US
Mailing Address - Phone:413-536-7670
Mailing Address - Fax:413-536-7671
Practice Address - Street 1:185 HIGH ST
Practice Address - Street 2:
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-6504
Practice Address - Country:US
Practice Address - Phone:413-536-7670
Practice Address - Fax:413-536-7671
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-29
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4830156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0353264Medicaid
09398OtherSPECTERA
38856OtherBC BS DAVIS
MA4830OtherEYE MED
MA0780820001Medicare NSC