National Provider Identifier Database

GREAT RIVER ONCOLOGY PC
Hematology & Oncology

An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.


Contact Information

GREAT RIVER ONCOLOGY, P.C.
1225 S GEAR AVE
SUITE 152
WEST BURLINGTON, IA52655-1691
Phone: 319-753-1220
Fax: 319-753-5464
Website:
Specialty Taxonomy Code
* Hematology & Oncology 207RH0003X

* Indicates primary specialty

NPI Profile & details for GREAT RIVER ONCOLOGY, P.C.

NPI Number 1649297326
Legal business name
LBN
GREAT RIVER ONCOLOGY, P.C.
Authorized official ROHINI REGANTI - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 07/17/2006
Last updated 08/22/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers
  • IA Medicaid: 0274860
  • IA Other: 08894 BCBS GROUP PROVIDER NUMBE

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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