Provider Demographics
NPI:1336132562
Name:ONCOLOGY HEMATOLOGY CARE, INC.
Entity Type:Organization
Organization Name:ONCOLOGY HEMATOLOGY CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:R
Authorized Official - Last Name:BROUN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-751-2145
Mailing Address - Street 1:5053 WOOSTER RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45226-2326
Mailing Address - Country:US
Mailing Address - Phone:513-751-2145
Mailing Address - Fax:513-751-2138
Practice Address - Street 1:781 W LOCUST ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:OH
Practice Address - Zip Code:45177-2116
Practice Address - Country:US
Practice Address - Phone:937-283-2273
Practice Address - Fax:937-283-2280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-23
Last Update Date:2015-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0655018Medicaid
OH9920792Medicare PIN