Provider Demographics
NPI:1215940895
Name:ONCOLOGY & HEMATOLOGY ASSOC INC
Entity type:Organization
Organization Name:ONCOLOGY & HEMATOLOGY ASSOC INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CTRL IN CANCER CTRS
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENSPAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:317-964-5200
Mailing Address - Street 1:6845 RAMA DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-1707
Mailing Address - Country:US
Mailing Address - Phone:317-964-5267
Mailing Address - Fax:317-964-5391
Practice Address - Street 1:6845 RAMA DR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46219-1707
Practice Address - Country:US
Practice Address - Phone:317-964-5267
Practice Address - Fax:317-964-5391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN60005762A3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN2004308304AMedicaid
1536955OtherNCPDP PROVIDER IDENTIFICATION NUMBER
0765130002Medicare NSC