Provider Demographics
NPI:1952342321
Name:REGIONAL CANCER CARE, P.A.
Entity Type:Organization
Organization Name:REGIONAL CANCER CARE, P.A.
Other - Org Name:CANCER CENTER OF DURHAM. P.C.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARSHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BRITT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-829-4476
Mailing Address - Street 1:4506 S. MIAMI BOULEVARD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-5077
Mailing Address - Country:US
Mailing Address - Phone:919-477-0047
Mailing Address - Fax:919-477-6919
Practice Address - Street 1:4506 S. MIAMI BOULEVARD
Practice Address - Street 2:SUITE 150
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-5077
Practice Address - Country:US
Practice Address - Phone:919-477-0047
Practice Address - Fax:919-477-6919
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REGIONAL CANCER CARE. P.A.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-09
Last Update Date:2015-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890211XMedicaid
NC890211XMedicaid