Provider Demographics
NPI:1164610135
Name:DR. RICHARD B. STENDER
Entity Type:Organization
Organization Name:DR. RICHARD B. STENDER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:B
Authorized Official - Last Name:STENDER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:304-652-2459
Mailing Address - Street 1:624 WELLS ST
Mailing Address - Street 2:
Mailing Address - City:SISTERSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:26175-1324
Mailing Address - Country:US
Mailing Address - Phone:304-652-2459
Mailing Address - Fax:304-652-2459
Practice Address - Street 1:624 WELLS ST
Practice Address - Street 2:
Practice Address - City:SISTERSVILLE
Practice Address - State:WV
Practice Address - Zip Code:26175-1324
Practice Address - Country:US
Practice Address - Phone:304-652-2459
Practice Address - Fax:304-652-2459
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-04
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV607-OD152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVT32536Medicare UPIN
WV0590200001Medicare NSC
WV1164610135Medicare NSC