Provider Demographics
NPI:1003943721
Name:CINCINNATI HEMATOLOGY ONCOLOGY INC
Entity Type:Organization
Organization Name:CINCINNATI HEMATOLOGY ONCOLOGY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OF CORPORATION
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:L
Authorized Official - Last Name:CODY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-321-4333
Mailing Address - Street 1:2727 MADISON RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45209-2276
Mailing Address - Country:US
Mailing Address - Phone:513-321-4333
Mailing Address - Fax:513-533-6033
Practice Address - Street 1:2727 MADISON RD
Practice Address - Street 2:SUITE 400
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45209-2276
Practice Address - Country:US
Practice Address - Phone:513-321-4333
Practice Address - Fax:513-533-6033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2008-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH32667174400000X
OH40534174400000X
OH61751174400000X
OH72179174400000X
OH68352174400000X
OH71313174400000X
OH86350174400000X
OH85883174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY65919409Medicaid
KY65919409Medicaid
KY5030Medicare PIN