Organization
LUCKY EYE CARE, PLLC
Active
Other names
Malinda Lucky Flores, OD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MALINDA LUCKY FLORES O.D. (OWNER)
(304) 375-4748
Entity
Organization
Contact information
Practice address
123 WEST WAGNER, ELLENBORO, WV 26346
(304) 869-3028
Mailing address
37 ALEXANDER DR, WILLIAMSTOWN, WV 26187-8302
(304) 375-4748
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
951-OD
WV
332H00000X
Eyewear Supplier
WV 951-OD
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001711137
BCBS
WV
01
—
410044882
RAILROAD MEDICARE
WV
Enumeration date
09/25/2007
Last updated
05/16/2008
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