Provider Demographics
NPI:1821084088
Name:CINCINNATI HEMATOLOGY-ONCOLOGY, INC
Entity Type:Organization
Organization Name:CINCINNATI HEMATOLOGY-ONCOLOGY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR/C.O.O.
Authorized Official - Prefix:MRS
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:L
Authorized Official - Last Name:KENDRICK
Authorized Official - Suffix:
Authorized Official - Credentials:JD,MHA,FACHE,FACMPE
Authorized Official - Phone:513-321-4333
Mailing Address - Street 1:2727 MADISON RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45209-2276
Mailing Address - Country:US
Mailing Address - Phone:513-321-4333
Mailing Address - Fax:513-533-6033
Practice Address - Street 1:2727 MADISON RD
Practice Address - Street 2:SUITE 400
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45209-2276
Practice Address - Country:US
Practice Address - Phone:513-321-4333
Practice Address - Fax:513-533-6033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH32667207RH0003X
OH40534207RH0003X
OH61751207RH0003X
OH68352207RH0003X
OH71313207RH0003X
OH86350207RH0003X
OH85883207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0827896Medicaid
OH2218193Medicaid
OH2010568Medicaid
OH0156790Medicaid
OH0179462Medicaid
OH0395862Medicaid
OHH74524Medicare UPIN
OHC01718Medicare UPIN
OH0395862Medicaid
OHB48000Medicare UPIN
OHI33011Medicare UPIN
OH0179462Medicaid
OH0156790Medicaid
OH2010568Medicaid
OHG75992Medicare UPIN