Provider Demographics
NPI:1952607327
Name:CANCER CENTERS OF NORTH CAROLINA, PC
Entity Type:Organization
Organization Name:CANCER CENTERS OF NORTH CAROLINA, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:GRATES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-829-4450
Mailing Address - Street 1:PO BOX 60106
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0106
Mailing Address - Country:US
Mailing Address - Phone:919-826-4460
Mailing Address - Fax:919-829-4470
Practice Address - Street 1:300 ASHVILLE AVE
Practice Address - Street 2:STE. 110
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-8682
Practice Address - Country:US
Practice Address - Phone:919-854-4588
Practice Address - Fax:919-854-9950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-02
Last Update Date:2012-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Multi-Specialty