Provider Demographics
NPI:1609034107
Name:HARVEY SCHLETER O.D. PSC
Entity Type:Organization
Organization Name:HARVEY SCHLETER O.D. PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HARVEY
Authorized Official - Middle Name:AUGUST
Authorized Official - Last Name:SCHLETER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:606-679-5177
Mailing Address - Street 1:709 E MOUNT VERNON ST
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42501-1338
Mailing Address - Country:US
Mailing Address - Phone:606-679-5155
Mailing Address - Fax:606-678-9200
Practice Address - Street 1:709 E MOUNT VERNON ST
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42501-1338
Practice Address - Country:US
Practice Address - Phone:606-679-5155
Practice Address - Fax:606-678-9200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-30
Last Update Date:2011-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY960DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY77009603Medicaid
KY00742Medicare PIN