Basic Information
Provider Information
NPI: 1205967106
EntityType: 2
ReplacementNPI:  
OrganizationName: ONCOLOGY HEMATOLOGY CARE, INC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 860 NW WASHINGTON BLVD
Address2:  
City: HAMILTON
State: OH
PostalCode: 450136340
CountryCode: US
TelephoneNumber: 5138966940
FaxNumber: 5138966947
Practice Location
Address1: 860 NW WASHINGTON BLVD
Address2:  
City: HAMILTON
State: OH
PostalCode: 450136340
CountryCode: US
TelephoneNumber: 5138966940
FaxNumber: 5138966947
Other Information
ProviderEnumerationDate: 03/09/2007
LastUpdateDate: 05/20/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: BROUN
AuthorizedOfficialFirstName: EDWARD
AuthorizedOfficialMiddleName: R
AuthorizedOfficialTitleorPosition: PRESIDENT
AuthorizedOfficialTelephone: 5137512145
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: MD
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
251F00000X  Y AgenciesHome Infusion 

No ID Information.


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