Healthcare Provider Details
I. General information
NPI: 1316254337
Provider Name (Legal Business Name): RC CANCER CENTERS - DECATUR
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/13/2010
Last Update Date: 10/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2349 LAWRENCEVILLE HWY
DECATUR GA
30033-3143
US
IV. Provider business mailing address
53 PERIMETER CTR E SUITE 500
ATLANTA GA
30346-2294
US
V. Phone/Fax
- Phone: 404-320-1550
- Fax:
- Phone: 770-682-2099
- Fax: 866-281-8389
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QX0203X |
| Taxonomy | Radiation Oncology Clinic/Center |
| License Number | |
| License Number State | GA |
VIII. Authorized Official
Name:
VICTORIA
BECK
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 770-682-2099