Basic Information
| Provider Information | |||||||||
| NPI: | 1376702639 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | THE DON AND SYBIL HARRINGTON CANCER CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 51628 | ||||||||
| Address2: | |||||||||
| City: | AMARILLO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 791591628 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8063545875 | ||||||||
| FaxNumber: | 8063545892 | ||||||||
| Practice Location | |||||||||
| Address1: | 1500 WALLACE BLVD | ||||||||
| Address2: | |||||||||
| City: | AMARILLO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 791061794 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8063545875 | ||||||||
| FaxNumber: | 8063545892 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/03/2008 | ||||||||
| LastUpdateDate: | 01/12/2009 | ||||||||
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| AuthorizedOfficialLastName: | TAYLOR | ||||||||
| AuthorizedOfficialFirstName: | JAMES | ||||||||
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| AuthorizedOfficialTitleorPosition: | C.O.O. | ||||||||
| AuthorizedOfficialTelephone: | 8063545875 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 291U00000X | 45D0660694 | TX | Y | Laboratories | Clinical Medical Laboratory |
ID Information
| ID | Type | State | Issuer | Description | 130260603 | 05 | TX | MEDICAID |