Provider Demographics
NPI:1710291885
Name:MEDICAL CENTER OF HIGH POINT CANCER CENTER
Entity Type:Organization
Organization Name:MEDICAL CENTER OF HIGH POINT CANCER CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:TIM
Authorized Official - Middle Name:
Authorized Official - Last Name:RICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-832-7000
Mailing Address - Street 1:2630 WILLARD DAIRY RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27265-8351
Mailing Address - Country:US
Mailing Address - Phone:336-884-3888
Mailing Address - Fax:
Practice Address - Street 1:2630 WILLARD DAIRY RD
Practice Address - Street 2:SUITE 300
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-8351
Practice Address - Country:US
Practice Address - Phone:336-884-3888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MOSES CONE HEALTH SYSTEM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-08-01
Last Update Date:2010-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5004814261QX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0200XAmbulatory Health Care FacilitiesClinic/CenterOncology