Basic Information
| Provider Information | |||||||||
| NPI: | 1386807576 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ALLIANCE ONCOLOGY LLC | ||||||||
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| OtherOrganizationName: | COMMONWEALTH NEWBURYPORT CANCER CENTER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 BAYVIEW CIR | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | NEWPORT BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926602983 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9492425384 | ||||||||
| FaxNumber: | 4802128589 | ||||||||
| Practice Location | |||||||||
| Address1: | 1 WALLACE BASHAW WAY | ||||||||
| Address2: | |||||||||
| City: | NEWBURYPORT | ||||||||
| State: | MA | ||||||||
| PostalCode: | 01950 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8002297226 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/08/2008 | ||||||||
| LastUpdateDate: | 10/04/2012 | ||||||||
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| AuthorizedOfficialLastName: | WEEKS | ||||||||
| AuthorizedOfficialFirstName: | MICHAEL | ||||||||
| AuthorizedOfficialMiddleName: | C. | ||||||||
| AuthorizedOfficialTitleorPosition: | VP FINANCE | ||||||||
| AuthorizedOfficialTelephone: | 2563833325 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0001X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology | 261QX0203X | MA | Y | Ambulatory Health Care Facilities | Clinic/Center | Oncology, Radiation |
No ID Information.