Organization
MARTINSBURG OPTICAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JULIA REGINA SMALL (PRESIDENT/OWNER)
(304) 263-3095
Entity
Organization
Contact information
Practice address
608 W ADDITION ST, MARTINSBURG, WV 25401-2614
(304) 263-3095
(304) 263-6339
Mailing address
608 W ADDITION ST, MARTINSBURG, WV 25401-2614
(304) 263-3095
(304) 263-6339
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001709848
BLUECROSS BLUESHIELD
WV
05
—
0151710000
—
WV
Enumeration date
09/28/2006
Last updated
07/21/2022
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