Healthcare Provider Details
I. General information
NPI: 1063416808
Provider Name (Legal Business Name): ONCOLOGY HEMATOLOGY CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/09/2005
Last Update Date: 06/24/2022
Certification Date: 06/24/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4350 MALSBARY RD
CINCINNATI OH
45242-5621
US
IV. Provider business mailing address
5053 WOOSTER RD
CINCINNATI OH
45226-2326
US
V. Phone/Fax
- Phone: 513-751-2273
- Fax: 513-792-5844
- Phone: 513-751-2145
- Fax: 513-751-2138
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207VX0201X |
| Taxonomy | Gynecologic Oncology Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0001X |
| Taxonomy | Radiation Oncology Physician |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RX0202X |
| Taxonomy | Medical Oncology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
EDWARD
R
BROUN
Title or Position: PRESIDENT
Credential: MD
Phone: 513-751-2145