Healthcare Provider Details

I. General information

NPI: 1326038258
Provider Name (Legal Business Name): CANCER CARE OF WNC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2005
Last Update Date: 06/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 HOSPITAL DR 4TH FLOOR
ASHEVILLE NC
28801-4550
US

IV. Provider business mailing address

21 HOSPITAL DR 4TH FLOOR
ASHEVILLE NC
28801-4550
US

V. Phone/Fax

Practice location:
  • Phone: 828-253-4262
  • Fax: 828-418-0926
Mailing address:
  • Phone: 828-253-4262
  • Fax: 828-418-0926

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. MARGARET V. BEAZLEY
Title or Position: ADMINISTRATOR
Credential:
Phone: 828-253-4262