Provider Demographics
NPI:1881884195
Name:CARLSBAD REGIONAL OSCOLOGY CENTER
Entity type:Organization
Organization Name:CARLSBAD REGIONAL OSCOLOGY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHROCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:575-887-0412
Mailing Address - Street 1:1008 W PIERCE ST
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:CARLSBAD
Mailing Address - State:NM
Mailing Address - Zip Code:88220-2001
Mailing Address - Country:US
Mailing Address - Phone:575-887-0412
Mailing Address - Fax:575-887-0579
Practice Address - Street 1:2428 WEST PIERCE STREET
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:NM
Practice Address - Zip Code:88220-3512
Practice Address - Country:US
Practice Address - Phone:575-302-3530
Practice Address - Fax:575-437-8205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-01
Last Update Date:2010-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMA100807Medicare PIN
NMF46293Medicare UPIN