Provider Demographics
NPI:1215075221
Name:TRI-COUNTY HEMATOLOGY & ONCOLOGY ASSOCIATES, INC.
Entity type:Organization
Organization Name:TRI-COUNTY HEMATOLOGY & ONCOLOGY ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FAROUQ
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-478-0001
Mailing Address - Street 1:7337 CARITAS CIR NW
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44646-9118
Mailing Address - Country:US
Mailing Address - Phone:330-478-0001
Mailing Address - Fax:330-837-2646
Practice Address - Street 1:7337 CARITAS CIR NW
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646-9118
Practice Address - Country:US
Practice Address - Phone:330-478-0001
Practice Address - Fax:330-837-2646
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH02-12001003336C0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH02-1200100OtherPHARMACY ID NUMBER
OH3675381OtherNCPDP NUMBER
OH2044639Medicaid
OH2044639Medicaid
OH1056550001Medicare NSC