Provider Demographics
NPI:1194329698
Name:HARROD-VAGEDES, PAIGE
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:
Last Name:HARROD-VAGEDES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 BRIARCLIFF RD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45415-3425
Mailing Address - Country:US
Mailing Address - Phone:937-277-1985
Mailing Address - Fax:
Practice Address - Street 1:300 BRIARCLIFF RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45415-3425
Practice Address - Country:US
Practice Address - Phone:937-277-1985
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-24
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant