Provider Demographics
NPI:1669637179
Name:RANSON OPTICAL CENTER
Entity Type:Organization
Organization Name:RANSON OPTICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RHEA
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:PRUITT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-725-8866
Mailing Address - Street 1:217 OAK LEE DR STE 12B
Mailing Address - Street 2:
Mailing Address - City:RANSON
Mailing Address - State:WV
Mailing Address - Zip Code:25438-4866
Mailing Address - Country:US
Mailing Address - Phone:304-725-8866
Mailing Address - Fax:304-725-8874
Practice Address - Street 1:217 OAK LEE DR STE 12B
Practice Address - Street 2:
Practice Address - City:RANSON
Practice Address - State:WV
Practice Address - Zip Code:25438-4866
Practice Address - Country:US
Practice Address - Phone:304-725-8866
Practice Address - Fax:304-725-8874
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-23
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier