Provider Demographics
NPI:1578600201
Name:TRI-COUNTY HEMATOLOGY & ONCOLOGY ASSOCIATES INC
Entity Type:Organization
Organization Name:TRI-COUNTY HEMATOLOGY & ONCOLOGY ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NOMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RAFIQUE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-478-0001
Mailing Address - Street 1:7337 CARITAS CIR NW
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44646-9118
Mailing Address - Country:US
Mailing Address - Phone:330-478-0001
Mailing Address - Fax:330-837-2646
Practice Address - Street 1:7337 CARITAS CIR NW
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646-9118
Practice Address - Country:US
Practice Address - Phone:330-478-0001
Practice Address - Fax:330-837-2646
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2020-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2044639Medicaid
OH1056550001Medicare NSC
OH2044639Medicaid