Organization
EYECANDY OF WEST VIRGINIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES DARRELL RUDD (OWNER)
(681) 238-5537
Entity
Organization
Contact information
Practice address
808 N EISENHOWER DR, BECKLEY, WV 25801-3129
(681) 238-5537
Mailing address
808 N EISENHOWER DR, BECKLEY, WV 25801-3129
(681) 238-5537
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
—
—
332BC3200X
Customized Equipment (DME)
—
—
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
06/09/2022
Last updated
10/26/2022
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