Healthcare Provider Details

I. General information

NPI: 1215940895
Provider Name (Legal Business Name): ONCOLOGY & HEMATOLOGY ASSOC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 03/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6845 RAMA DR
INDIANAPOLIS IN
46219-1707
US

IV. Provider business mailing address

6845 RAMA DR
INDIANAPOLIS IN
46219-1707
US

V. Phone/Fax

Practice location:
  • Phone: 317-964-5267
  • Fax: 317-964-5391
Mailing address:
  • Phone: 317-964-5267
  • Fax: 317-964-5391

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number60005762A
License Number StateIN

VIII. Authorized Official

Name: ANDREW GREENSPAN
Title or Position: PRESIDENT CTRL IN CANCER CTRS
Credential: MD
Phone: 317-964-5200