Provider Demographics
NPI:1932715638
Name:FRITZ, OLIVIA MARIE (PHARMD)
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:MARIE
Last Name:FRITZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 E BROAD ST STE 109
Mailing Address - Street 2:
Mailing Address - City:ELYRIA
Mailing Address - State:OH
Mailing Address - Zip Code:44035-6429
Mailing Address - Country:US
Mailing Address - Phone:440-329-7300
Mailing Address - Fax:440-329-7441
Practice Address - Street 1:125 E BROAD ST STE 109
Practice Address - Street 2:
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-6429
Practice Address - Country:US
Practice Address - Phone:440-329-7300
Practice Address - Fax:440-329-7441
Is Sole Proprietor?:No
Enumeration Date:2020-09-17
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03439883183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist