Basic Information
| Provider Information | |||||||||
| NPI: | 1780613000 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SHENANDOAH ONCOLOGY ASSOCIATES, PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1870 AMHERST ST | ||||||||
| Address2: | SUITE F | ||||||||
| City: | WINCHESTER | ||||||||
| State: | VA | ||||||||
| PostalCode: | 226012873 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5406621108 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1870 AMHERST ST | ||||||||
| Address2: | SUITE F | ||||||||
| City: | WINCHESTER | ||||||||
| State: | VA | ||||||||
| PostalCode: | 226012873 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5406621108 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/30/2006 | ||||||||
| LastUpdateDate: | 08/20/2008 | ||||||||
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| AuthorizedOfficialLastName: | GUAY | ||||||||
| AuthorizedOfficialFirstName: | JOANN | ||||||||
| AuthorizedOfficialMiddleName: | L | ||||||||
| AuthorizedOfficialTitleorPosition: | BILLING MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 5406621108 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | CPC | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0003X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
ID Information
| ID | Type | State | Issuer | Description | 052198 | 01 | VA | BLUE CROSS BLUE SHIELD | OTHER |