MEDICARE: ONCOLOGY/ HEMATOLOGY CARE, 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	207RH0003X	Hematology & Oncology Physician
2	207RX0202X	Medical Oncology Physician

Other Identifiers

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

General Provider Information

NPI Number	:	1720082472
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ONCOLOGY/ HEMATOLOGY CARE, INC.

Provider Business Mailing Address
First Line	:	5053 WOOSTER ROAD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45226
Country	:	US
Telephone Number	:	513-751-2145
Fax Number	:	513-751-2138

Provider Business Practice Location Address
First Line	:	4777 E GALBRAITH RD STE 320
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45236-2725
Country	:	US
Telephone Number	:	513-751-2273
Fax Number	:	513-793-6290

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MR. PAUL DIETER
Credential	:
Telephone Number	:	513-751-2145

Provider Enumeration Date	:	06/10/2005
Last Update Date	:	10/17/2019

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