Provider Demographics
NPI:1912073560
Name:RAYS OPTICAL SERVICE, INC.
Entity Type:Organization
Organization Name:RAYS OPTICAL SERVICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SEC TREAS
Authorized Official - Prefix:MRS
Authorized Official - First Name:SONJA
Authorized Official - Middle Name:J
Authorized Official - Last Name:MOODY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-963-1298
Mailing Address - Street 1:1125 W COLUMBIA AVE
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49015-3031
Mailing Address - Country:US
Mailing Address - Phone:269-963-1298
Mailing Address - Fax:269-963-5950
Practice Address - Street 1:1125 W COLUMBIA AVE
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-3031
Practice Address - Country:US
Practice Address - Phone:269-963-1298
Practice Address - Fax:269-963-5950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-27
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2230127OtherUNITED HEALTH & IBA
MIOA30276OtherBCBS
0852870001Medicare ID - Type Unspecified