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NPI Code Detail

MEDICARE: BLANCHARD VALLEY REGIONAL CANCER CENTER LLC

MEDICARE: BLANCHARD VALLEY REGIONAL CANCER CENTER LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0001XRadiation Oncology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2P00349396OTHEROHRAILROAD CARE

General Provider Information

NPI Number : 1194824862
Entity Type Code : Organization
Provider Name (Legal Business Name) : BLANCHARD VALLEY REGIONAL CANCER CENTER LLC
Provider Business Mailing Address
First Line : PO BOX 636320
Second Line :
City : CINCINNATI
State : OH
Zip : 45263-6320
Country : US
Telephone Number : 419-429-6499
Fax Number : 419-429-6494
Provider Business Practice Location Address
First Line : 15990 MEDICAL DR S
Second Line :
City : FINDLAY
State : OH
Zip : 45840-8894
Country : US
Telephone Number : 419-423-3703
Fax Number : 419-427-0212
Authorized Official
Title or Position : VP FINANCE
Name : DAVID M CYTLAK
Credential :
Telephone Number : 419-423-5497
Provider Enumeration Date : 09/21/2006
Last Update Date : 04/09/2014

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Directions to “BLANCHARD VALLEY REGIONAL CANCER CENTER LLC ” Practice Location

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