MEDICARE: HEMATOLOGY-ONCOLOGY-HEMATOPATHOLOGY, INC.

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
1	207ZH0000X	Hematology (Pathology) Physician	35-028869	OH
2	207RH0003X	Hematology & Oncology Physician	35-028869	OH

General Provider Information

NPI Number	:	1437401734
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEMATOLOGY-ONCOLOGY-HEMATOPATHOLOGY, INC.

Provider Business Mailing Address
First Line	:	1939 RIDGE RD
Second Line	:	P.O. BOX 396
City	:	HINCKLEY
State	:	OH
Zip	:	44233-9301
Country	:	US
Telephone Number	:	330-225-3475
Fax Number	:	330-225-3865

Provider Business Practice Location Address
First Line	:	7225 OLD OAK BLVD
Second Line	:	SUITE B317
City	:	CLEVELAND
State	:	OH
Zip	:	44130-3339
Country	:	US
Telephone Number	:	440-816-2724
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	LAWRENCE KASS
Credential	:	M.D.
Telephone Number	:	330-225-3475

Provider Enumeration Date	:	10/10/2012
Last Update Date	:	10/10/2012

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