Healthcare Provider Details

I. General information

NPI: 1265870331
Provider Name (Legal Business Name): REGIONAL CANCER CARE ASSOCIATES, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2013
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 RESERVOIR RD NW
WASHINGTON DC
20007-2113
US

IV. Provider business mailing address

PO BOX 789216
PHILADELPHIA PA
19178-9216
US

V. Phone/Fax

Practice location:
  • Phone: 202-444-3736
  • Fax: 202-444-0939
Mailing address:
  • Phone: 201-883-0193
  • Fax: 201-883-0175

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. TERRILL JORDAN
Title or Position: PRESIDENT/CEO
Credential:
Phone: 201-510-0910