Provider Demographics
NPI:1407011778
Name:WINFIELD EYE CARE CENTER, INC.
Entity Type:Organization
Organization Name:WINFIELD EYE CARE CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:CROWDER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:304-733-5355
Mailing Address - Street 1:3540 ROUTE 60 EAST
Mailing Address - Street 2:
Mailing Address - City:BARBOURSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25504-1639
Mailing Address - Country:US
Mailing Address - Phone:304-733-5355
Mailing Address - Fax:304-733-9743
Practice Address - Street 1:3540 ROUTE 60 EAST
Practice Address - Street 2:
Practice Address - City:BARBOURSVILLE
Practice Address - State:WV
Practice Address - Zip Code:25504-1639
Practice Address - Country:US
Practice Address - Phone:304-733-5355
Practice Address - Fax:304-733-9743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-25
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVWV-889-OD152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVWI9330971Medicare PIN