ONCOLOGY HEMATOLOGY ASSOCIATION INC

Provider Demographics

• NPI: 1861469223
• Name: ONCOLOGY HEMATOLOGY ASSOCIATION INC
• Entity Type: Organization
• Organization Name: ONCOLOGY HEMATOLOGY ASSOCIATION INC
• Authorized Official - Title/Position: SR.DIRECTOR
• Authorized Official - First Name: MARK
• Authorized Official - Middle Name: T
• Authorized Official - Last Name: EHALT
• Authorized Official - Phone: 412-647-0943
• Mailing Address - Street 1: 2 HOT METAL ST
• Mailing Address - Street 2: QUANTUM ONE, N430
• Mailing Address - City: PITTSBURGH
• Mailing Address - State: PA
• Mailing Address - Zip Code: 15203-2348
• Mailing Address - Country: US
• Mailing Address - Phone: 412-432-7706
• Mailing Address - Fax: 412-432-7691
• Practice Address - Street 1: 5115 CENTRE AVE
• Practice Address - Street 2: 3RD FLOOR
• Practice Address - City: PITTSBURGH
• Practice Address - State: PA
• Practice Address - Zip Code: 15232-1301
• Practice Address - Country: US
• Practice Address - Phone: 412-235-1020
• Practice Address - Fax: 412-235-1030
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2006-03-03
• Last Update Date: 2013-01-29

Provider Licenses

State	License ID	Taxonomies
		207RH0003X
PA	39D0911309	291U00000X
PA	39D0179384	291U00000X
PA	39D0979602	291U00000X
PA	39D0671037	291U00000X
PA	39D0979600	291U00000X
PA	39D0860900	291U00000X
PA	39D0929849	291U00000X
PA	39D0683973	291U00000X
PA	39D0671038	291U00000X
PA	39D0988205	291U00000X
PA	39D1056766	291U00000X
PA	39D0890691	291U00000X

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization	Group
Yes	207RH0003X	Allopathic & Osteopathic Physicians	Internal Medicine	Hematology & Oncology	Group - Multi-Specialty
No	291U00000X	Laboratories	Clinical Medical Laboratory

Provider Identifiers

State	Identifier ID	ID Type	Issuer
PA	0016480750056	Other	CLIA LAB
WV	001743629	Other	MOUNTAIN STATE BLUE CROSS BLUE SHIELD
OH	2524898	Medicaid
PA	0016480750055	Other	CLIA LAB
PA	0016480750057	Other	CLIA LAB
OH	2524923	Medicaid
OH	2568627	Medicaid
PA	0016480750058	Other	CLIA LAB
PA	0016480750061	Other	CLIA LAB
PA	0016480750063	Other	CLIA LAB
PA	0016480750064	Other	CLIA LAB
PA	0016480750065	Other	CLIA LAB
OH	2524905	Medicaid
OH	2658440	Medicaid
OH	2659449	Medicaid
OH	2717108	Medicaid
OH	000000158940	Other	ANTHEM BLUE CROSS BLUE SHIELD
PA	0016480750060	Other	CLIA LAB
OH	2571195	Medicaid
PA	0016480750059	Other	CLIA LAB
OH	2702650	Medicaid
PA	001648075	Medicaid
OH	2518654	Medicaid
OH	2538347	Medicaid
OH	ON9251731	Medicare PIN
OH	DD0522	Medicare PIN
PA	0016480750065	Other	CLIA LAB
PA	0016480750059	Other	CLIA LAB
WV	ON9251732	Medicare PIN