Provider Demographics
NPI:1558358309
Name:TOLEDO RADIATION ONCOLOGY, INC
Entity Type:Organization
Organization Name:TOLEDO RADIATION ONCOLOGY, INC
Other - Org Name:T R O INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:G
Authorized Official - Last Name:HENNING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-471-0493
Mailing Address - Street 1:4841 MONROE ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-4385
Mailing Address - Country:US
Mailing Address - Phone:419-471-0493
Mailing Address - Fax:419-472-2772
Practice Address - Street 1:4841 MONROE ST
Practice Address - Street 2:SUITE 103
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-4385
Practice Address - Country:US
Practice Address - Phone:419-471-0493
Practice Address - Fax:419-472-2772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-05
Last Update Date:2011-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
No261QX0203XAmbulatory Health Care FacilitiesClinic/CenterOncology, RadiationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2147126Medicaid
OHCG1282OtherRR MEDICARE
OH2147126Medicaid
OHCG1282OtherRR MEDICARE