Provider Demographics
NPI:1124024450
Name:HEMATOLOGY ONCOLOGY ASSOCIATES PC
Entity Type:Organization
Organization Name:HEMATOLOGY ONCOLOGY ASSOCIATES PC
Other - Org Name:CANCER CENTER OF THE ROCKIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MD
Authorized Official - Prefix:MRS
Authorized Official - First Name:MIHO
Authorized Official - Middle Name:T
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:970-493-6337
Mailing Address - Street 1:2121 E HARMONY RD
Mailing Address - Street 2:UNIT 150
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80528-3413
Mailing Address - Country:US
Mailing Address - Phone:970-493-6337
Mailing Address - Fax:970-493-3528
Practice Address - Street 1:2121 E HARMONY RD
Practice Address - Street 2:UNIT 150
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80528-3413
Practice Address - Country:US
Practice Address - Phone:970-493-6337
Practice Address - Fax:970-493-3528
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY107761900OtherMEDICAID WYOMING
CO04008256Medicaid
CO04008256Medicaid
NE=========00OtherMEDICAID NEBRASKA
COCS2491Medicare PIN
NE=========00Medicaid
CO04008256Medicaid