Provider Demographics
NPI:1235157108
Name:SALEK OPTICAL INC
Entity Type:Organization
Organization Name:SALEK OPTICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:TERRENCE
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:SALEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-287-2748
Mailing Address - Street 1:1200 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SWOYERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18704-1318
Mailing Address - Country:US
Mailing Address - Phone:570-287-2748
Mailing Address - Fax:570-287-5240
Practice Address - Street 1:1200 MAIN ST
Practice Address - Street 2:
Practice Address - City:SWOYERSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18704-1318
Practice Address - Country:US
Practice Address - Phone:570-287-2748
Practice Address - Fax:570-287-5240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2011-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA6000000836332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0173140001Medicare NSC