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NPI Code Detail

MEDICARE: ONCOLOGY CARE LLC

MEDICARE: ONCOLOGY CARE 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
1174400000XSpecialistMD021901EPA

Other Identifiers

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

General Provider Information

NPI Number : 1194739482
Entity Type Code : Organization
Provider Name (Legal Business Name) : ONCOLOGY CARE LLC
Provider Business Mailing Address
First Line : 2 FRANKLIN TOWN BLVD
Second Line : SUITE #100
City : PHILADELPHIA
State : PA
Zip : 19103-1238
Country : US
Telephone Number : 215-599-1100
Fax Number : 215-599-2485
Provider Business Practice Location Address
First Line : 2 FRANKLIN TOWN BLVD
Second Line : SUITE #100
City : PHILADELPHIA
State : PA
Zip : 19103-1238
Country : US
Telephone Number : 215-599-1100
Fax Number : 215-599-2485
Authorized Official
Title or Position : PROPRIETOR
Name : DR. DONNA J GLOVER
Credential : M.D
Telephone Number : 215-599-1100
Provider Enumeration Date : 07/29/2006
Last Update Date : 11/21/2007

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