Healthcare Provider Details

I. General information

NPI: 1447579644
Provider Name (Legal Business Name): ALABAMA CANCER CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2010
Last Update Date: 05/28/2024
Certification Date: 05/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

402 SOUTH 1ST STREET
GADSDEN AL
35901-5202
US

IV. Provider business mailing address

509 ENERGY CENTER BLVD STE 804
NORTHPORT AL
35473-2798
US

V. Phone/Fax

Practice location:
  • Phone: 256-547-0536
  • Fax: 256-547-8703
Mailing address:
  • Phone: 205-345-7892
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberMD.30196
License Number StateAL

VIII. Authorized Official

Name: ASHVINI SENGAR
Title or Position: PRESIDENT
Credential: MD
Phone: 256-547-0536