1548264138 NPI number — ONCOLOGY/ HEMATOLOGY CARE, INC.

Table of content: (NPI 1548264138)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548264138 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:
1548264138
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/04/2017
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:
860 NW WASHINGTON BLVD
Provider Second Line Business Practice Location Address:
SUITE E
Provider Business Practice Location Address City Name:
HAMILTON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45013-6382
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-896-6940
Provider Business Practice Location Address Fax Number:
513-896-6947
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" .

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

  • Identifier: 2000042 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




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