Provider Demographics
NPI:1770025652
Name:AULTMAN RADIATION ONCOLOGY OF ALLIANCE COMMUNITY HOSP
Entity Type:Organization
Organization Name:AULTMAN RADIATION ONCOLOGY OF ALLIANCE COMMUNITY HOSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:M
Authorized Official - Last Name:LUNTZ
Authorized Official - Suffix:
Authorized Official - Credentials:CFO
Authorized Official - Phone:330-452-9911
Mailing Address - Street 1:2600 SIXTH ST SW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44710-1799
Mailing Address - Country:US
Mailing Address - Phone:330-452-9911
Mailing Address - Fax:330-588-4799
Practice Address - Street 1:885 SOUTH SAWBURG AVE SUITE 108
Practice Address - Street 2:
Practice Address - City:ALLIANCE
Practice Address - State:OH
Practice Address - Zip Code:44601-5926
Practice Address - Country:US
Practice Address - Phone:330-823-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-09
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
284300000X
OH284300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes284300000XHospitalsSpecial Hospital