Provider Demographics
NPI:1912154071
Name:ADVANCED RADIATION THERAPY LLC
Entity type:Organization
Organization Name:ADVANCED RADIATION THERAPY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FACILITY ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:BACHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MPA
Authorized Official - Phone:973-625-6792
Mailing Address - Street 1:400 W BLACKWELL ST
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07801-2525
Mailing Address - Country:US
Mailing Address - Phone:973-625-6792
Mailing Address - Fax:973-983-5575
Practice Address - Street 1:400 W BLACKWELL ST
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NJ
Practice Address - Zip Code:07801-2525
Practice Address - Country:US
Practice Address - Phone:973-625-6792
Practice Address - Fax:973-983-5575
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SAINT CLARES HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-08-20
Last Update Date:2008-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0203XAmbulatory Health Care FacilitiesClinic/CenterOncology, Radiation