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General NPI Number Information
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NPI Number | 1013266048
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Entity Type | Organization
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Legal Business Name | MCCREARY CANCER CENTER
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Dates
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Enumeration Date | 09/06/2012
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Last Update Date | 05/06/2015
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Provider Practice Location Address
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Address Line | 212 MULBERRY STREET SW
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City | LENOIR
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State | NC
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Zip | 28645
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Country | US
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Telephone | 828-759-4960
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Fax | 828-759-4961
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Provider Business Mailing Address
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Address Line | 212 MULBERRY STREET SW
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City | LENOIR
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State | NC
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Zip | 28645
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Country | US
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Telephone | 828-759-4960
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Fax | 828-759-4961
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Authorized Official
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Title or Position | DIRECTOR OF PHARMACY
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Name | BENJAMIN ROWELL DANIELS
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Credential | PHARMD
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Telephone | 984-974-7744
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QX0200X
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Taxonomy Name | Oncology Clinic/Center
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License Number | 12599
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License Number State | NC
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