Provider Demographics
NPI:1386688596
Name:CANCER CARE OF WNC
Entity Type:Organization
Organization Name:CANCER CARE OF WNC
Other - Org Name:CANCER CARE OF WNC AT FRANKLIN
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:V
Authorized Official - Last Name:BEAZLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-253-4262
Mailing Address - Street 1:21 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-4550
Mailing Address - Country:US
Mailing Address - Phone:828-253-4262
Mailing Address - Fax:828-418-0926
Practice Address - Street 1:834 DEPOT STREET
Practice Address - Street 2:SUITE 210
Practice Address - City:FRANKLIN
Practice Address - State:NC
Practice Address - Zip Code:28734-2651
Practice Address - Country:US
Practice Address - Phone:828-253-4262
Practice Address - Fax:828-418-0926
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CANCER CARE OF WNC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-16
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5908602Medicaid
NC02548OtherBLUE CROSS BLUE SHIELD NC
NC=========OtherTAX ID
NC02548OtherBLUE CROSS BLUE SHIELD NC