Provider Demographics
NPI:1730491234
Name:COLUMBUS RADIATION ONCOLOGY TREATMENT CENTER LLC
Entity Type:Organization
Organization Name:COLUMBUS RADIATION ONCOLOGY TREATMENT CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:E
Authorized Official - Last Name:ELDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-660-6342
Mailing Address - Street 1:2121 WARM SPRINGS RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-7955
Mailing Address - Country:US
Mailing Address - Phone:706-660-8121
Mailing Address - Fax:706-323-4205
Practice Address - Street 1:2121 WARM SPRINGS RD
Practice Address - Street 2:SUITE B
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-7955
Practice Address - Country:US
Practice Address - Phone:706-660-8121
Practice Address - Fax:706-323-4205
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COLUMBUS AMBULATORY HEALTHCARE SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-07-13
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0203XAmbulatory Health Care FacilitiesClinic/CenterOncology, Radiation