| Name: | The Eyeglass Store, Inc. |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Profit Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 10 Dec 1991 (33 years ago) |
| Identification Number: | 000066218 |
| ZIP code: | 02860 |
| County: | Providence County |
| Principal Address: | 2 DEXTER STREET, PAWTUCKET, RI, 02860, USA |
| Purpose: | TO CONDUCT THE GENERAL PRACTICE OF OPTOMETRY |
| Fictitious names: |
Family Eye Care Services of Pawtucket (trading name, 1998-11-04 - ) |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1437290889 | 2007-02-09 | 2008-04-17 | 2 DEXTER ST, PAWTUCKET, RI, 028602991, US | 2 DEXTER ST, PAWTUCKET, RI, 028602991, US | |||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||
| Phone | +1 401-723-9540 |
| Fax | 4017256583 |
Authorized person
| Name | DR. JONATHAN D KAPLAN |
| Role | OPTOMETRIST |
| Phone | 4017239540 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| License Number | ODTG00494 |
| State | RI |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS |
| Number | 7959-2 |
| State | RI |
| Issuer | MEDICAID |
| Number | FE00663 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| DR. JONATHAN D. KAPLAN | Agent | 2 DEXTER STREET, PAWTUCKET, RI, 02860, USA |
| Name | Role | Address |
|---|---|---|
| JONATHAN D KAPLAN OD | PRESIDENT | 60 SCARBOROUGH ROAD CUMBERLAND, RI 02864 USA |
| Name | Role | Address |
|---|---|---|
| MELISSA J KAPLAN | TREASURER | 60 SCARBOROUGH ROAD CUMBERLAND, RI 02864 USA |
| Name | Role | Address |
|---|---|---|
| JONATHAN D KAPLAN OD | SECRETARY | 60 SCARBOROUGH ROAD CUMBERLAND, RI 02864 USA |
| Name | Role | Address |
|---|---|---|
| JONATHAN D KAPLAN OD | DIRECTOR | 60 SCARBOROUGH ROAD CUMBERLAND, RI 02864 USA |
| Number | Name | File Date |
|---|---|---|
| 202444775690 | Annual Report | 2024-01-26 |
| 202326649310 | Annual Report | 2023-01-26 |
| 202208246460 | Annual Report | 2022-01-20 |
| 202183864530 | Annual Report | 2021-01-04 |
| 202031091420 | Annual Report | 2020-01-04 |
| 201983803110 | Annual Report | 2019-01-05 |
| 201855570740 | Annual Report | 2018-01-02 |
| 201729435270 | Annual Report | 2017-01-04 |
| 201689940290 | Annual Report | 2016-01-03 |
| 201552691630 | Annual Report | 2015-01-04 |
Date of last update: 07 Oct 2024
Sources: Rhode Island Department of State
