Provider Demographics
NPI:1114235975
Name:RADIOTHERAPY CANCER CENTERS LLC - CHEROKEE
Entity Type:Organization
Organization Name:RADIOTHERAPY CANCER CENTERS LLC - CHEROKEE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-682-2099
Mailing Address - Street 1:53 PERIMETER CTR E
Mailing Address - Street 2:SUITE 500
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30346-2294
Mailing Address - Country:US
Mailing Address - Phone:770-682-2099
Mailing Address - Fax:866-281-8389
Practice Address - Street 1:1200 OAKSIDE DR
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30114-2430
Practice Address - Country:US
Practice Address - Phone:770-479-1761
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-15
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2010PROFS-0025261QX0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0203XAmbulatory Health Care FacilitiesClinic/CenterOncology, Radiation
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA2010PROFS-0025OtherLICENSE