Healthcare Provider Details

I. General information

NPI: 1689860207
Provider Name (Legal Business Name): BLOOD & CANCER CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2007
Last Update Date: 04/30/2024
Certification Date: 04/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3695A BOARDMAN CANFIELD RD
CANFIELD OH
44406-9009
US

IV. Provider business mailing address

3695A BOARDMAN CANFIELD RD
CANFIELD OH
44406-9009
US

V. Phone/Fax

Practice location:
  • Phone: 330-533-3040
  • Fax: 330-533-9459
Mailing address:
  • Phone: 330-533-3040
  • Fax: 330-533-9459

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number100427
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State

VIII. Authorized Official

Name: MS. MARIA A ORTIZ ALVARADO
Title or Position: BILLING/CREDENTIALING
Credential:
Phone: 330-533-3040