Provider Demographics
NPI:1891841383
Name:CANCER SOCIETY OF ST. JOSEPH COUNTY
Entity Type:Organization
Organization Name:CANCER SOCIETY OF ST. JOSEPH COUNTY
Other - Org Name:RIVERBEND CANCER SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATE
Authorized Official - Middle Name:
Authorized Official - Last Name:VOELKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:574-287-4197
Mailing Address - Street 1:919 E JEFFERSON BLVD
Mailing Address - Street 2:SUITE 401
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46617-3112
Mailing Address - Country:US
Mailing Address - Phone:574-287-4197
Mailing Address - Fax:574-287-4393
Practice Address - Street 1:919 E JEFFERSON BLVD
Practice Address - Street 2:SUITE 401
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46617-3112
Practice Address - Country:US
Practice Address - Phone:574-287-4197
Practice Address - Fax:574-287-4393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable