Provider Demographics
NPI:1710924162
Name:RADIATION ONCOLOGY CENTERS OF THE CAROLINAS, INC.
Entity Type:Organization
Organization Name:RADIATION ONCOLOGY CENTERS OF THE CAROLINAS, INC.
Other - Org Name:MATTHEWS RADIATION ONCOLOGY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:A
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MSPH
Authorized Official - Phone:704-333-7376
Mailing Address - Street 1:200 QUEENS RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28204-3252
Mailing Address - Country:US
Mailing Address - Phone:704-333-7376
Mailing Address - Fax:704-333-3397
Practice Address - Street 1:1400 MATTHEWS TOWNSHIP PKWY
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-4655
Practice Address - Country:US
Practice Address - Phone:704-845-8800
Practice Address - Fax:704-845-8809
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RADIATION ONCOLOGY CENTERS OF THE CAROLINAS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-01
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
2572423OtherUNITED HEALTHCARE
NC890212BMedicaid
NC0212BOtherBLUE CROSS
SCGPO441Medicaid
NC890212BMedicaid