Organization
FOX VALLEY HEMATOLOGY AND ONCOLOGY, S.C.
Active
Parent organization
FOX VALLEY HEMATOLOGY AND ONCOLOGY, S.C
Organization subpart
Yes
Provider details
NPI number
Legal business name
FOX VALLEY HEMATOLOGY AND ONCOLOGY, S.C
Authorized official
MR. TIMOTHY F GOGGINS JR. MD (CHIEF MEDICAL OFFICER/PHYSICIAN)
(920) 749-1171
Entity
Organization
Contact information
Practice address
491 S WASHBURN ST, SUITE 101, OSHKOSH, WI 54904-6733
(920) 292-5548
Mailing address
3232 N BALLARD RD, SUITE 200, APPLETON, WI 54911-8804
(920) 749-9668
(920) 734-5307
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0886830004
DMEPOS - DMEMAC
WI
Enumeration date
03/23/2016
Last updated
02/07/2017
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