MEDICARE: RICHMOND CANCER AND BLOOD DISEASE CENTER

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

General Provider Information

NPI Number	:	1760648471
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RICHMOND CANCER AND BLOOD DISEASE CENTER

Provider Business Mailing Address
First Line	:	1050 REID PKWY
Second Line	:	SUITE 120
City	:	RICHMOND
State	:	IN
Zip	:	47374-1156
Country	:	US
Telephone Number	:	765-983-3245
Fax Number	:	765-983-3247

Provider Business Practice Location Address
First Line	:	1050 REID PKWY
Second Line	:	SUITE 120
City	:	RICHMOND
State	:	IN
Zip	:	47374-1156
Country	:	US
Telephone Number	:	765-983-3245
Fax Number	:	765-983-3247

Authorized Official
Title or Position	:	PRESIDENT
Name	:	BHARAT L AGRAWAL
Credential	:	MD
Telephone Number	:	765-983-3245

Provider Enumeration Date	:	08/01/2008
Last Update Date	:	08/01/2008

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