Provider Demographics
NPI:1093721250
Name:CANCER CARE CENTER OF YORK COUNTY
Entity Type:Organization
Organization Name:CANCER CARE CENTER OF YORK COUNTY
Other - Org Name:CCCYC
Other - Org Type:Other Name
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:G
Authorized Official - Last Name:SWALLOW
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:207-662-3998
Mailing Address - Street 1:22 BRAMHALL ST
Mailing Address - Street 2:MAINE MEDICAL CENTER ATTN: AL SWALLOW
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04102-3134
Mailing Address - Country:US
Mailing Address - Phone:207-662-3998
Mailing Address - Fax:207-662-6234
Practice Address - Street 1:27 INDUSTRIAL AVE
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:ME
Practice Address - Zip Code:04073-5820
Practice Address - Country:US
Practice Address - Phone:207-459-1606
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty