Provider Demographics
NPI:1922520808
Name:21ST CENTURY ONCOLOGY OF KENTUCKY LLC
Entity Type:Organization
Organization Name:21ST CENTURY ONCOLOGY OF KENTUCKY LLC
Other - Org Name:CANCER & BLOOD SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:COMMINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-931-7277
Mailing Address - Street 1:2160 COLONIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-1410
Mailing Address - Country:US
Mailing Address - Phone:239-931-7212
Mailing Address - Fax:239-931-7385
Practice Address - Street 1:1460 BLUEGRASS AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40215-1272
Practice Address - Country:US
Practice Address - Phone:502-361-8496
Practice Address - Fax:502-361-3377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-12
Last Update Date:2019-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical OncologyGroup - Single Specialty