Provider Demographics
NPI:1265513220
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:MD
Authorized Official - Phone:419-222-6595
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 1:13671 W PATTISON AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:KENTON
Practice Address - State:OH
Practice Address - Zip Code:43326-1185
Practice Address - Country:US
Practice Address - Phone:419-673-1006
Practice Address - Fax:419-673-1011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty