Healthcare Provider Details

I. General information

NPI: 1902835101
Provider Name (Legal Business Name): TRIANGLE RADIATION ONCOLOGY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4420 LAKE BOONE TRL
RALEIGH NC
27607-7505
US

IV. Provider business mailing address

PO BOX 16098
CHAPEL HILL NC
27516-6098
US

V. Phone/Fax

Practice location:
  • Phone: 919-784-3320
  • Fax: 919-783-0737
Mailing address:
  • Phone: 919-967-6646
  • Fax: 919-967-6647

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBERT D ORNITZ
Title or Position: PRESIDENT
Credential: MD
Phone: 919-784-3320