Provider Demographics
NPI:1003000217
Name:TRI-STATE EYE CARE CENTER, LTD.
Entity Type:Organization
Organization Name:TRI-STATE EYE CARE CENTER, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:L
Authorized Official - Last Name:RATCLIFF
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:304-523-4819
Mailing Address - Street 1:919 5TH AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-2003
Mailing Address - Country:US
Mailing Address - Phone:304-523-4819
Mailing Address - Fax:304-525-5551
Practice Address - Street 1:919 5TH AVE STE 100
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-2003
Practice Address - Country:US
Practice Address - Phone:304-523-4819
Practice Address - Fax:304-525-5551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-30
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty