MEDICARE: TOLEDO RADIATION ONCOLOGY, INC

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
1	261QX0203X	Radiation Oncology Clinic/Center
2	2085R0001X	Radiation Oncology Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	CG1282	OTHER	OH	RR MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1558358309
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOLEDO RADIATION ONCOLOGY, INC

Provider Business Mailing Address
First Line	:	4841 MONROE ST
Second Line	:	SUITE 103
City	:	TOLEDO
State	:	OH
Zip	:	43623-4385
Country	:	US
Telephone Number	:	419-471-0493
Fax Number	:	419-472-2772

Provider Business Practice Location Address
First Line	:	4841 MONROE ST
Second Line	:	SUITE 103
City	:	TOLEDO
State	:	OH
Zip	:	43623-4385
Country	:	US
Telephone Number	:	419-471-0493
Fax Number	:	419-472-2772

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MRS. TERRI G HENNING
Credential	:
Telephone Number	:	419-471-0493

Provider Enumeration Date	:	10/05/2005
Last Update Date	:	06/24/2011

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Directions to “TOLEDO RADIATION ONCOLOGY, INC ” Practice Location

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