Healthcare Provider Details

I. General information

NPI: 1326212929
Provider Name (Legal Business Name): FAGEDES AND GARRITY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2008
Last Update Date: 10/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

632 VINE ST STE 301
CINCINNATI OH
45202-2425
US

IV. Provider business mailing address

632 VINE ST. STE 301
CINCINNATI OH
45202-2436
US

V. Phone/Fax

Practice location:
  • Phone: 513-621-0979
  • Fax: 513-421-5345
Mailing address:
  • Phone: 513-621-0979
  • Fax: 513-421-5345

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number4194-T055
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: DR. JOHN J. GARRITY III
Title or Position: PARTNER
Credential: O.D.
Phone: 513-621-0979