Provider Demographics
NPI:1912009143
Name:HOPE CANCER CENTER OF NORTHWEST OHIO
Entity Type:Organization
Organization Name:HOPE CANCER CENTER OF NORTHWEST OHIO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAVI
Authorized Official - Middle Name:
Authorized Official - Last Name:MADAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-394-9696
Mailing Address - Street 1:825 W MARKET ST
Mailing Address - Street 2:SUITE 260
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45805-2799
Mailing Address - Country:US
Mailing Address - Phone:419-222-6595
Mailing Address - Fax:419-222-6640
Practice Address - Street 1:1103 E SPRING ST
Practice Address - Street 2:
Practice Address - City:SAINT MARYS
Practice Address - State:OH
Practice Address - Zip Code:45885-2403
Practice Address - Country:US
Practice Address - Phone:419-394-9696
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2435994Medicaid
OH2435994Medicaid