Provider Demographics
NPI:1013266048
Name:MCCREARY CANCER CENTER
Entity Type:Organization
Organization Name:MCCREARY CANCER CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:ROWELL
Authorized Official - Last Name:DANIELS
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:984-974-7744
Mailing Address - Street 1:212 MULBERRY STREET SW
Mailing Address - Street 2:
Mailing Address - City:LENOIR
Mailing Address - State:NC
Mailing Address - Zip Code:28645
Mailing Address - Country:US
Mailing Address - Phone:828-759-4960
Mailing Address - Fax:828-759-4961
Practice Address - Street 1:212 MULBERRY STREET SW
Practice Address - Street 2:
Practice Address - City:LENOIR
Practice Address - State:NC
Practice Address - Zip Code:28645
Practice Address - Country:US
Practice Address - Phone:828-759-4960
Practice Address - Fax:828-759-4961
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNC HOSPITALS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-09-06
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12599261QX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0200XAmbulatory Health Care FacilitiesClinic/CenterOncology