Provider Demographics
NPI:1366596744
Name:THE GERAD CENTER FOR CANCER TREATMENT LLC
Entity type:Organization
Organization Name:THE GERAD CENTER FOR CANCER TREATMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:
Authorized Official - Last Name:GERAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-222-3737
Mailing Address - Street 1:803 W MARKET ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45805
Mailing Address - Country:US
Mailing Address - Phone:419-222-3737
Mailing Address - Fax:419-229-3234
Practice Address - Street 1:803 W MARKET ST
Practice Address - Street 2:SUITE 200
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45805
Practice Address - Country:US
Practice Address - Phone:419-222-3737
Practice Address - Fax:419-229-3234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2301404Medicaid
OH2301440Medicaid
OH2501760Medicaid
OH2301397Medicaid
OH2301413Medicaid
OH2301397Medicaid
OH9319444Medicare PIN
OHCJ7307Medicare PIN
OH2301440Medicaid
OH2301404Medicaid