Provider Demographics
NPI:1104071893
Name:GAINESVILLE CANCER CENTER
Entity type:Organization
Organization Name:GAINESVILLE CANCER CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHERRI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-387-8000
Mailing Address - Street 1:PO BOX 270690
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75027-0690
Mailing Address - Country:US
Mailing Address - Phone:940-387-8000
Mailing Address - Fax:940-383-4797
Practice Address - Street 1:1615 HOSPITAL BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:GAINESVILLE
Practice Address - State:TX
Practice Address - Zip Code:76240
Practice Address - Country:US
Practice Address - Phone:940-387-8000
Practice Address - Fax:940-383-4797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-21
Last Update Date:2008-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK2566174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty