Organization
RX OPTICAL LABORATORIES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHAN J JEPSON (PRESIDENT)
(269) 342-0003
Entity
Organization
Contact information
Practice address
590 E 16TH ST STE 20, HOLLAND, MI 49423-3702
(269) 342-0003
Mailing address
1825 S PARK ST, KALAMAZOO, MI 49001-2762
(269) 342-0003
(269) 342-4284
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
900C976550
BCBS
MI
Enumeration date
05/17/2018
Last updated
05/17/2018
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