Basic Information
| Provider Information | |||||||||
| NPI: | 1568572436 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | THE DON & SYBIL HARRINGTON CANCER CENTER, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 51628 | ||||||||
| Address2: | |||||||||
| City: | AMARILLO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 791591628 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8063594673 | ||||||||
| FaxNumber: | 8063545892 | ||||||||
| Practice Location | |||||||||
| Address1: | 1500 WALLACE BLVD | ||||||||
| Address2: | |||||||||
| City: | AMARILLO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 791061794 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8063594673 | ||||||||
| FaxNumber: | 8063545892 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/30/2006 | ||||||||
| LastUpdateDate: | 11/15/2011 | ||||||||
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| AuthorizedOfficialLastName: | HANCOCK | ||||||||
| AuthorizedOfficialFirstName: | PAUL | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 8063594673 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR0206X | N | Ambulatory Health Care Facilities | Clinic/Center | Radiology, Mammography | 261QR0207X | N | Ambulatory Health Care Facilities | Clinic/Center | Radiology, Mobile Mammography | 261QX0200X | N | Ambulatory Health Care Facilities | Clinic/Center | Oncology | 261QX0203X | Y | Ambulatory Health Care Facilities | Clinic/Center | Oncology, Radiation |
ID Information
| ID | Type | State | Issuer | Description | 00PT24 | 01 | TX | BLUE CROSS BLUE SHIELD | OTHER | 130260605 | 05 | TX | MEDICAID |