Provider Demographics
NPI:1295913002
Name:HR OPTICAL INC
Entity type:Organization
Organization Name:HR OPTICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTICIAN
Authorized Official - Prefix:
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:K
Authorized Official - Last Name:REYNOLDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-679-8469
Mailing Address - Street 1:246 POPLAR AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42503-1701
Mailing Address - Country:US
Mailing Address - Phone:606-679-8469
Mailing Address - Fax:606-678-8891
Practice Address - Street 1:246 POPLAR AVE
Practice Address - Street 2:STE 1
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-1701
Practice Address - Country:US
Practice Address - Phone:606-679-8469
Practice Address - Fax:606-678-8891
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-04
Last Update Date:2013-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
KY929156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY50525OtherDAVIS VISION
KY52800950Medicaid
KY627OtherSTERLING VISION SERVICE
KY1176629OtherCHA HUMANA HEALTH
KY000000340307OtherBLUE CROSS BLUE SHIELD
KY10199OtherSPECTERA
KY180021OtherNATIONAL VISION ADMINISTR
KYOP1414OtherEYEMED
KY180021OtherNATIONAL VISION ADMINISTR