Organization
CANCER NETWORK OF WEST CENTRAL OHIO
Active
Parent organization
THE CANCER NETWORK OF WEST CENTRAL OHIO
Other names
Grand Lake Regional Cancer Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE CANCER NETWORK OF WEST CENTRAL OHIO
Authorized official
MR. PAUL CLEMMENTS (MANAGING EXECUTIVE)
(419) 251-2662
Entity
Organization
Contact information
Practice address
900 HAVEMANN ROAD, CELINA, OH 45822-1870
(419) 584-1900
Mailing address
900 HAVEMANN ROAD, CELINA, OH 45822-1870
(419) 584-1900
Taxonomy
Speciality
Code
Description
License number
State
261QX0203X
Radiation Oncology Clinic/Center
Primary
1055RT
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2429821
—
OH
Enumeration date
06/27/2006
Last updated
05/15/2019
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