Provider Demographics
NPI:1750610945
Name:ANDREW W RULA OD LLC
Entity type:Organization
Organization Name:ANDREW W RULA OD LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:RULA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:757-374-5060
Mailing Address - Street 1:3812 MARLIN BAY CT
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23455-2909
Mailing Address - Country:US
Mailing Address - Phone:757-374-5060
Mailing Address - Fax:
Practice Address - Street 1:100 NEWMARKET SQ
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23605-2730
Practice Address - Country:US
Practice Address - Phone:757-374-5060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-17
Last Update Date:2009-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618001576152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty