Provider Demographics
NPI:1639493034
Name:BLOOD AND CANCER CARE OF OHIO, LLC
Entity Type:Organization
Organization Name:BLOOD AND CANCER CARE OF OHIO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:R
Authorized Official - Last Name:LAUFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-336-8380
Mailing Address - Street 1:4272 DUBLIN RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43221-5000
Mailing Address - Country:US
Mailing Address - Phone:614-319-3196
Mailing Address - Fax:614-319-3198
Practice Address - Street 1:2975 DONNYLANE BLVD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-3228
Practice Address - Country:US
Practice Address - Phone:614-336-8380
Practice Address - Fax:614-336-8557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-15
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35039256207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3037494Medicaid
OH3037494Medicaid
OH=========051OtherCARESOURCE