Provider Demographics
NPI:1407837214
Name:R & R OPTICAL INC
Entity type:Organization
Organization Name:R & R OPTICAL INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:R
Authorized Official - Last Name:ROSSELLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-867-5045
Mailing Address - Street 1:PO BOX 10077
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16805-0077
Mailing Address - Country:US
Mailing Address - Phone:814-867-5045
Mailing Address - Fax:814-867-5044
Practice Address - Street 1:237 NORTHLAND CTR
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16803-2900
Practice Address - Country:US
Practice Address - Phone:814-231-8542
Practice Address - Fax:814-235-0838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA6000004634332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
393654OtherNVA
393654OtherNVA