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NPI Code Detail

MEDICARE: HEMATOLOGY ONCOLOGY OF SALEM CORP LLC

MEDICARE: HEMATOLOGY ONCOLOGY OF SALEM CORP 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
1207RH0003XHematology & Oncology Physician

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1DA6849OTHEROHMEDICARE RAILROAD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2383695927OTHEROHTRICARE

General Provider Information

NPI Number : 1790754083
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEMATOLOGY ONCOLOGY OF SALEM CORP LLC
Provider Business Mailing Address
First Line : PO BOX 22925
Second Line :
City : BEACHWOOD
State : OH
Zip : 44122-0925
Country : US
Telephone Number : 330-332-5306
Fax Number : 330-332-7674
Provider Business Practice Location Address
First Line : 1995 E STATE ST
Second Line :
City : SALEM
State : OH
Zip : 44460-2423
Country : US
Telephone Number : 330-332-7672
Fax Number : 330-332-7674
Authorized Official
Title or Position : PRESIDENT
Name : DR. ZORAIDA A MENDEZ
Credential : MD
Telephone Number : 330-332-7672
Provider Enumeration Date : 03/17/2006
Last Update Date : 10/10/2013

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Directions to “HEMATOLOGY ONCOLOGY OF SALEM CORP LLC ” Practice Location

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