Provider Demographics
NPI:1912959016
Name:HEMATOLOGY ONCOLOGY CENTER INC
Entity Type:Organization
Organization Name:HEMATOLOGY ONCOLOGY CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BELAGODU
Authorized Official - Middle Name:N
Authorized Official - Last Name:KANTHARAJ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-324-0401
Mailing Address - Street 1:41201 SCHADDEN RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:ELYRIA
Mailing Address - State:OH
Mailing Address - Zip Code:44035-2220
Mailing Address - Country:US
Mailing Address - Phone:440-324-0401
Mailing Address - Fax:440-324-0405
Practice Address - Street 1:41201 SCHADDEN RD
Practice Address - Street 2:SUITE 2
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-2220
Practice Address - Country:US
Practice Address - Phone:440-324-0401
Practice Address - Fax:440-324-0405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0279541Medicaid
OH1513889OtherUNITED MINE WORKERS
OHHE9285372Medicare ID - Type Unspecified
OH1146370001Medicare NSC