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Organization
ONCOLOGY HEMATOLOGY ASSOCIATES OF CENTRAL ILLINOIS
Active
Organization
ONCOLOGY HEMATOLOGY ASSOCIATES OF CENTRAL ILLINOIS
Active
Other names
Illinois Cancer Care
Organization subpart
No
Provider details
NPI number
Authorized official
JASON HARLOW (PHARMACIST IN CHARGE)
(309) 243-3404
Entity
Organization
Contact information
Practice address
3105 MAGORY DRIVE, BLOOMINGTON, IL 61704
(309) 243-9018
(309) 243-3075
Mailing address
3105 MAGORY DRIVE, BLOOMINGTON, IL 61704
(309) 243-9018
(309) 243-3075
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
054.019361
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2152589
PK
—
Enumeration date
06/24/2015
Last updated
06/24/2015
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