Provider Demographics
NPI:1548585896
Name:COMMUNITY CANCER CENTER OF LIMA INC.
Entity Type:Organization
Organization Name:COMMUNITY CANCER CENTER OF LIMA INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:OSEI
Authorized Official - Middle Name:T
Authorized Official - Last Name:OWUSU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:567-525-5140
Mailing Address - Street 1:300 W WALLACE ST
Mailing Address - Street 2:SUITE B4
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-1242
Mailing Address - Country:US
Mailing Address - Phone:567-525-5140
Mailing Address - Fax:567-525-5144
Practice Address - Street 1:300 W WALLACE ST
Practice Address - Street 2:SUITE B4
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-1242
Practice Address - Country:US
Practice Address - Phone:567-525-5140
Practice Address - Fax:567-525-5144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-30
Last Update Date:2012-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35086969207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2586518Medicaid
OH2586518Medicaid
OHOW7347881Medicare PIN