Provider Demographics
NPI:1396742557
Name:MEDICAL ONCOLOGY ASSOCIATES, INC.
Entity type:Organization
Organization Name:MEDICAL ONCOLOGY ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:ALI
Authorized Official - Last Name:VARGHAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-997-7785
Mailing Address - Street 1:29349 GATES MILLS BLVD
Mailing Address - Street 2:
Mailing Address - City:PEPPER PIKE
Mailing Address - State:OH
Mailing Address - Zip Code:44124-4651
Mailing Address - Country:US
Mailing Address - Phone:216-831-6493
Mailing Address - Fax:216-831-6413
Practice Address - Street 1:2412 LAKE AVE
Practice Address - Street 2:
Practice Address - City:ASHTABULA
Practice Address - State:OH
Practice Address - Zip Code:44004-4977
Practice Address - Country:US
Practice Address - Phone:440-997-7785
Practice Address - Fax:440-998-0652
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-02
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35 . 053339261QM2500X, 261QX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0200XAmbulatory Health Care FacilitiesClinic/CenterOncology
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0858602Medicaid
OH0971355Medicaid
E07223Medicare UPIN
OH9163012Medicare ID - Type Unspecified
OH0971355Medicaid