# MAIN LINE ONCOLOGY HEMATOLOGY ASSOC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508104043
- **Authorized official:** CHRISSA L LOVE (REVENUE CYCLE SUPERVISOR)
- **Authorized official phone:** (610) 645-2494

## Contact information

- **Practice address:** 100 E LANCASTER AVE, CANCER CENTER, WYNNEWOOD, PA 19096-3450
- **Practice address phone:** (610) 645-2494
- **Practice address fax:** (610) 645-4452
- **Mailing address:** 100 E LANCASTER AVE STE B20, WYNNEWOOD, PA 19096-3450
- **Mailing address phone:** (610) 645-2494
- **Mailing address fax:** (610) 645-4456

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LA2200X | Adult Health Nurse Practitioner | SP012692 | PA | Yes |

## Other

- **Enumeration date:** 01/17/2013
- **Last updated:** 08/03/2021