Provider Demographics
NPI:1447579644
Name:ALABAMA CANCER CARE, LLC
Entity Type:Organization
Organization Name:ALABAMA CANCER CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ASHVINI
Authorized Official - Middle Name:
Authorized Official - Last Name:SENGAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-547-0536
Mailing Address - Street 1:355 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35901-5202
Mailing Address - Country:US
Mailing Address - Phone:256-547-0536
Mailing Address - Fax:
Practice Address - Street 1:171 TOWN CENTER DR STE 6
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36205
Practice Address - Country:US
Practice Address - Phone:256-847-3369
Practice Address - Fax:256-847-3469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-27
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.30196207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
H55725Medicare UPIN