=====================================================
General NPI Number Information
=====================================================
NPI Number | 1376702639
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THE DON AND SYBIL HARRINGTON CANCER CENTER
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/03/2008
-----------------------------------------------------
Last Update Date | 01/12/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1500 WALLACE BLVD
-----------------------------------------------------
City | AMARILLO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 79106-1794
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 806-354-5875
-----------------------------------------------------
Fax | 806-354-5892
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 51628
-----------------------------------------------------
City | AMARILLO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 79159-1628
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 806-354-5875
-----------------------------------------------------
Fax | 806-354-5892
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | C.O.O.
-----------------------------------------------------
Name | JAMES TAYLOR
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 806-354-5875
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 291U00000X
-----------------------------------------------------
Taxonomy Name | Clinical Medical Laboratory
-----------------------------------------------------
License Number | 45D0660694
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------