Provider Demographics
NPI:1437391190
Name:THE GEORGIA CENTER FOR TOTAL CANCER CARE AT PRESTON RIDGE
Entity type:Organization
Organization Name:THE GEORGIA CENTER FOR TOTAL CANCER CARE AT PRESTON RIDGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DALE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MCCORD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-255-7402
Mailing Address - Street 1:3330 PRESTON RIDGE DRIVE
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-3330
Mailing Address - Country:US
Mailing Address - Phone:770-255-7500
Mailing Address - Fax:770-255-7501
Practice Address - Street 1:3330 PRESTON RIDGE
Practice Address - Street 2:100
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-3330
Practice Address - Country:US
Practice Address - Phone:770-255-7500
Practice Address - Fax:770-255-7501
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMERICAN PROFESSIONAL ASSOCIATES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-03-27
Last Update Date:2016-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty