Provider Demographics
NPI:1770722431
Name:SATILLA REGIONAL CANCER TREATMENT CENTER
Entity type:Organization
Organization Name:SATILLA REGIONAL CANCER TREATMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-272-2255
Mailing Address - Street 1:PO BOX 24650
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32241-4650
Mailing Address - Country:US
Mailing Address - Phone:904-260-6335
Mailing Address - Fax:
Practice Address - Street 1:101 SEYMOUR AVE
Practice Address - Street 2:
Practice Address - City:DOUGLAS
Practice Address - State:GA
Practice Address - Zip Code:31533-1917
Practice Address - Country:US
Practice Address - Phone:912-383-0815
Practice Address - Fax:912-383-0826
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SATILLA REGIONAL CANCER TREATMENT CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-02-19
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA055248207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty