Provider Demographics
NPI:1629190772
Name:SOMERSET VISION CENTER
Entity Type:Organization
Organization Name:SOMERSET VISION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:
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 MT VERNON STREET
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42501
Mailing Address - Country:US
Mailing Address - Phone:606-679-5177
Mailing Address - Fax:606-678-9200
Practice Address - Street 1:709 E MT VERNON STREET
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42501
Practice Address - Country:US
Practice Address - Phone:606-679-5177
Practice Address - Fax:606-678-9200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY77903730Medicaid
KY1235020001OtherDMERC