Provider Demographics
NPI:1083800908
Name:HOPE CANCER CENTER OF NORTHWEST OHIO
Entity Type:Organization
Organization Name:HOPE CANCER CENTER OF NORTHWEST OHIO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAVI
Authorized Official - Middle Name:
Authorized Official - Last Name:MADAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-222-6595
Mailing Address - Street 1:825 W MARKET ST
Mailing Address - Street 2:260
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45805-2799
Mailing Address - Country:US
Mailing Address - Phone:419-222-6595
Mailing Address - Fax:419-222-6640
Practice Address - Street 1:525 N EASTOWN RD
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45807-2268
Practice Address - Country:US
Practice Address - Phone:419-998-8288
Practice Address - Fax:419-998-8289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-25
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9334231Medicaid
OH9334233Medicare PIN