Provider Demographics
NPI:1598801540
Name:NORTH COAST CANCER CARE, INC
Entity Type:Organization
Organization Name:NORTH COAST CANCER CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:GALE
Authorized Official - Last Name:ROSHON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-626-9090
Mailing Address - Street 1:509 W MCPHERSON HWY
Mailing Address - Street 2:
Mailing Address - City:CLYDE
Mailing Address - State:OH
Mailing Address - Zip Code:43410-1107
Mailing Address - Country:US
Mailing Address - Phone:419-547-9500
Mailing Address - Fax:419-547-9400
Practice Address - Street 1:509 W MCPHERSON HWY
Practice Address - Street 2:
Practice Address - City:CLYDE
Practice Address - State:OH
Practice Address - Zip Code:43410-1107
Practice Address - Country:US
Practice Address - Phone:419-547-9500
Practice Address - Fax:419-547-9400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty