Healthcare Provider Details
I. General information
NPI: 1649504481
Provider Name (Legal Business Name): FAGEDES AND GARRITY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/28/2009
Last Update Date: 12/01/2016
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
35 E 7TH ST STE 400
CINCINNATI OH
45202-2488
US
V. Phone/Fax
- Phone: 513-621-0979
- Fax: 513-421-5345
- Phone: 513-621-0979
- Fax: 513-421-5345
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JOHN
J,
GARRITY
III
Title or Position: MANAGING MEMBER
Credential: OD
Phone: 513-621-0979