1164426813 NPI number — ONCOLOGY/ HEMATOLOGY CARE, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164426813 NPI number — ONCOLOGY/ HEMATOLOGY CARE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ONCOLOGY/ HEMATOLOGY CARE, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1164426813
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/20/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5053 WOOSTER RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CINCINNATI
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45226-2326
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-751-2145
Provider Business Mailing Address Fax Number:
513-751-2138

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
606 WILSON CREEK RD
Provider Second Line Business Practice Location Address:
STE 130
Provider Business Practice Location Address City Name:
LAWRENCEBURG
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47025-1035
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
812-537-1911
Provider Business Practice Location Address Fax Number:
812-537-5980
Provider Enumeration Date:
06/10/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BROUN
Authorized Official First Name:
EDWARD
Authorized Official Middle Name:
R
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
513-751-2145

Provider Taxonomy Codes

  • Taxonomy code: 207RH0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RX0202X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 2085R0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 200123880F , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".