Fox Valley Hematology & Oncology S C

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

9433-42 Issued in WI

Legal business name

FOX VALLEY HEMATOLOGY & ONCOLOGY S C

Practice address

3925 N Gateway Dr
Suite 100
Appleton, WI 54913-7863

Phone

(920) 702-4802

Fax

(920) 702-4319

NPI assigned

Jan 19, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Timothy Goggins

Title

Chief Medical Officer/Physician

Phone

(920) 749-1171

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Fox Valley Family Pharmacy Doing business as

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Avi Bar-Lev, M.D.

  • Hematology & Oncology Physician
  • Appleton, WI
  • NPI 1124163407
  NPD (past)
• Adam Edward Luboff, PHARMACIST

  • Pharmacist
  • Appleton, WI
  • NPI 1750820759
  NPD (past)
• Ronan H Smyth, MD

  • Diagnostic Radiology Physician
  • Green Bay, WI
  • NPI 1578619979
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1484784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494201600000",
    "number": "1003352733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3232 N BALLARD RD",
            "address_2": "SUITE 200",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549118804",
            "telephone_number": "920-749-9668",
            "fax_number": "920-734-5307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3925 N GATEWAY DR",
            "address_2": "SUITE 100",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549137863",
            "telephone_number": "920-702-4802",
            "fax_number": "920-702-4319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOX VALLEY HEMATOLOGY & ONCOLOGY S C",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-19",
        "last_updated": "2017-05-08",
        "status": "A",
        "authorized_official_last_name": "GOGGINS",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER/PHYSICIAN",
        "authorized_official_telephone_number": "920-749-1171"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WI",
            "license": "9433-42",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2167333",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fox Valley Family Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Appleton, WI
• Providers in Appleton, WI by specialty
• Community/Retail Pharmacy in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.