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NPI Code Detail

MEDICARE: CANCER NETWORK OF WEST CENTRAL OHIO

MEDICARE: CANCER NETWORK OF WEST CENTRAL OHIO
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
1261QX0203XRadiation Oncology Clinic/Center1056RTOH

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 : 1932139607
Entity Type Code : Organization
Provider Name (Legal Business Name) : CANCER NETWORK OF WEST CENTRAL OHIO
Provider Business Mailing Address
First Line : 900 HAVEMANN ROAD
Second Line :
City : CELINA
State : OH
Zip : 45822-1870
Country : US
Telephone Number : 419-584-1900
Fax Number :
Provider Business Practice Location Address
First Line : 2160 EWING CRAWFIS CIRCLE
Second Line :
City : BELLEFONTAINE
State : OH
Zip : 43311-9042
Country : US
Telephone Number : 937-592-9221
Fax Number :
Authorized Official
Title or Position : MANAGING EXECUTIVE
Name : MS. CHRISTINE A PROVAZNIK
Credential :
Telephone Number : 419-226-9103
Provider Enumeration Date : 07/05/2006
Last Update Date : 02/22/2008

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Directions to “CANCER NETWORK OF WEST CENTRAL OHIO ” Practice Location

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