Provider Demographics
NPI:1821789322
Name:MCPC-25 LLC
Entity Type:Organization
Organization Name:MCPC-25 LLC
Other - Org Name:FIRSTHEALTH RADIATION ONCOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICKEY
Authorized Official - Middle Name:
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-715-4473
Mailing Address - Street 1:135 PAGE RD N
Mailing Address - Street 2:
Mailing Address - City:PINEHURST
Mailing Address - State:NC
Mailing Address - Zip Code:28374-4607
Mailing Address - Country:US
Mailing Address - Phone:910-715-1056
Mailing Address - Fax:
Practice Address - Street 1:135 PAGE RD N
Practice Address - Street 2:
Practice Address - City:PINEHURST
Practice Address - State:NC
Practice Address - Zip Code:28374-4607
Practice Address - Country:US
Practice Address - Phone:910-715-1056
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-16
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Multi-Specialty