Organization
ALLIANCE CANCER SPECIALISTS
Active
Parent organization
CONSULTANTS IN MEDICAL ONCOLOGY & HEMATOLOGY, PC
Other names
Main Line Oncology Hematology Associates
Organization subpart
Yes
Provider details
NPI number
Legal business name
CONSULTANTS IN MEDICAL ONCOLOGY & HEMATOLOGY, PC
Authorized official
KIM DISTASIO (PRACTICE MANAGER)
(610) 645-2494
Entity
Organization
Contact information
Practice address
100 LANCASTER AVE, WYNNEWOOD, PA 19096
(610) 645-2494
(610) 645-4456
Mailing address
100 E LANCASTER AVENUE SUITE 100, WYNNEWOOD, PA 19096
(610) 645-2494
(610) 645-4456
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
MC542764A
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000279824
BLUE SHIELD
—
01
—
0094364000
BLUE CROSS
—
05
—
919262
—
PA
Enumeration date
08/31/2006
Last updated
02/24/2022
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us