Healthcare Provider Details

I. General information

NPI: 1649974718
Provider Name (Legal Business Name): SHARON GINGERICH LICENSED OPTICIAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2023
Last Update Date: 03/30/2023
Certification Date: 03/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7730 SAWMILL RD
DUBLIN OH
43016-9297
US

IV. Provider business mailing address

7730 SAWMILL RD
DUBLIN OH
43016-9297
US

V. Phone/Fax

Practice location:
  • Phone: 614-943-6508
  • Fax: 614-717-9183
Mailing address:
  • Phone: 614-943-6508
  • Fax: 614-717-9183

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number006991-S
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: