BLOOD AND CANCER CLINIC, PA (NPI# 1174747711) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1174747711 |
Entity Type | Organization |
Organization Name | BLOOD AND CANCER CLINIC, PA |
Practice Address |
2125 Valleygate Dr Suite 101 Fayetteville NC 28304-3657 |
Mailing Address |
Po Box 53095 Fayetteville NC 28305-3095 |
Practice Telephone | 9104838586 |
Practice Fax Number | 9104839212 |
Mailing Telephone | 9104838586 |
Mailing Fax Number | 9104839212 |
Enumeration Date | 2007-04-13 |
Last Update Date | 2020-08-22 |
Authorized Official Name | DR. SHIRISH D DEVASTHALI (PRESIDENT) |
Authorized Official Telephone | 9104838586 |
Authorized Official Credential | MD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 332900000X | Non-Pharmacy Dispensing Site | Suppliers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NC | BOARD OF PHARMACY | 02699 | 01 |
NC | NCPDP NUMBER | 3400936 | 01 |
NC | LICENSE NUMBER | 38929 | 01 |
NC | BOARD OF PHARMACY | 02701 | 01 |
Street Address |
2125 VALLEYGATE DR SUITE 101 |
City | FAYETTEVILLE |
State | NC |
Zip Code | 28304-3657 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1467455899 | All American Rehabilitation Solutions | Physical Therapist | 2125 Valleygate Dr, Suite 101, Fayetteville, NC 28304-3753 | 2005-05-31 |
1528419744 | American Arthritis & Rheumatology Associates-nc Pllc | Internal Medicine | 2125 Valleygate Dr, Suite 201, Fayetteville, NC 28304-3753 | 2016-06-29 |
1538558663 | Katherine Cole | Physician Assistant | 2125 Valleygate Dr, Suite 201, Fayetteville, NC 28304-3753 | 2015-01-13 |
1013227495 | Shelley Barry Follett | Nurse Practitioner | 2125 Valleygate Dr, Suite 201, Fayetteville, NC 28304-3753 | 2010-10-19 |
1437275161 | Pamela Hudak | Physician Assistant | 2125 Valleygate Dr, Suite 201, Fayetteville, NC 28304-3753 | 2007-03-22 |
1134269251 | Seema S Devasthali | Physical Therapist | 2125 Valleygate Dr, Suite 101-a, Fayetteville, NC 28304-3657 | 2007-02-07 |
1649354317 | Casey Cathleen Benander | Physical Therapist | 2125 Valleygate Dr, Suite 101, Fayetteville, NC 28304-3753 | 2006-10-25 |
1356455059 | Lafayette Clinic, Pa | Internal Medicine | 2125 Valleygate Dr, Suite 201, Fayetteville, NC 28304-3753 | 2006-08-18 |
1780697326 | Gwenesta Barnum Melton | Internal Medicine | 2125 Valleygate Dr, Suite 201, Fayetteville, NC 28304-3753 | 2006-08-14 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1598301061 | Coast To Coast Bilingual Counseling | Social Worker | 910 Hope Mills Road, Fayetteville, NC 28304 | 2019-11-20 |
1811530561 | Frances L. Hurst | Technician | 6732 Carloway Dr, Fayetteville, NC 28304 | 2019-10-25 |
1538717764 | Rose Mary A O'conner | Technician | 3530 Madison Ave, Fayetteville, NC 28304 | 2019-08-30 |
1932756087 | Sally Frances Jones | Technician | 2053 Mango Circle, Fayetteville, NC 28304 | 2019-08-23 |
1326528803 | Jeneen Yvette Townsend | Counselor | 2671 Adams Lake Dr Apt F, Fayetteville, NC 28304 | 2018-08-15 |
1780179580 | Ma Cornelia Villavicencio Leano | Nurse Practitioner | 3081 Stone Carriage Cir Apt Z, Fayetteville, NC 28304 | 2018-06-25 |
1861986267 | Pediatric After Hours Care of Fayetteville | Pediatrics | 556 Sandhurst Drive, Fayetteville, NC 28304 | 2018-06-19 |
1700386133 | Good Night Medical of Ohio, LLC | Durable Medical Equipment & Medical Supplies | 405 Owen Dr Ste 202, Fayetteville, NC 28304 | 2018-02-12 |
1003321365 | Valleygate Dental Surgery Center of Fayetteville, LLC | Dentist | 2038 Litho Place, Fayetteville, NC 28304 | 2017-12-08 |
1871004663 | The Salt Project | Marriage & Family Therapist | 1611-b Owen Dr., Fayetteville, NC 28304 | 2017-10-19 |
Find all providers in zip 28304 |
Taxonomy Code | 332900000X |
Grouping | Suppliers |
Classification | Non-Pharmacy Dispensing Site |
A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1114437985 | Physician Comp Rx, LLC | Non-Pharmacy Dispensing Site | 540 E Appleby Rd Ste 104, Fayetteville, AR 72703-4114 | 2017-10-06 |
1336554153 | Urgent Cares of America Nc Inc | Non-Pharmacy Dispensing Site | 4401 Ramsey St, Suite 104, Fayetteville, NC 28311-2202 | 2014-07-01 |
1174955249 | Planned Parenthood of Central North Carolina, Inc. | Non-Pharmacy Dispensing Site | 4551 Yadkin Rd, Fayetteville, NC 28303-3421 | 2013-07-31 |
1205174141 | Urgent Cares of America North Carolina Inc | Non-Pharmacy Dispensing Site | 3007 Town Center Dr, 100-101, Fayetteville, NC 28306-3639 | 2013-01-28 |
1922255884 | Fayetteville Primary Care | Non-Pharmacy Dispensing Site | 1673 Owen Dr, Fayetteville, NC 28304-3425 | 2008-08-22 |
1902212541 | Breezewood Healthcare P A | Non-Pharmacy Dispensing Site | 200 Forsythe St, Fayetteville, NC 28303-5426 | 2014-07-03 |
1841531662 | Fayetteville Medical Clinic | Non-Pharmacy Dispensing Site | 3613 Raeford Rd, Suite B, Fayetteville, NC 28304-2113 | 2013-03-04 |
1700137791 | Merrell Foot Clinic, PC | Non-Pharmacy Dispensing Site | 2250 Thornton Taylor Pkwy, Suite B, Fayetteville, TN 37334-3651 | 2012-10-01 |
1700191186 | Cumberland Medical Associates | Non-Pharmacy Dispensing Site | 5085 Morganton Rd, 100, Fayetteville, NC 28314-1523 | 2010-08-10 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1952775108 | Urgent Cares of America North Carolina Inc | Non-Pharmacy Dispensing Site | 907 Us 401 Bypass, Laurinburg Commons, Laurinburg, NC 28352 | 2015-11-25 |
1417321381 | Urgent Cares of America Nc Inc | Non-Pharmacy Dispensing Site | 5214 Market St, Wilmington, NC 28405-4067 | 2015-11-16 |
1003280033 | Urgent Cares of America North Carolina Inc | Non-Pharmacy Dispensing Site | 825 Blowing Rock Blvd, Lenoir, NC 28645-3709 | 2015-11-13 |
1659741361 | Urgent Cares of America North Carolina Inc | Non-Pharmacy Dispensing Site | 1262 East Broad Avenue, Rockingham, NC 28379 | 2015-10-07 |
1740650456 | Urgent Cares of America North Carolina Inc | Non-Pharmacy Dispensing Site | 220 Us Highway 70 West, Garner, NC 27529 | 2015-10-07 |
1033589072 | Urgent Cares of America North Carolina Inc | Non-Pharmacy Dispensing Site | 6010 Glenwood Ave, Raleigh, NC 27612-2602 | 2015-10-02 |
1922478205 | Urgent Cares of America North Carolina Inc | Non-Pharmacy Dispensing Site | 910 N Madison Blvd, Suite B, Roxboro, NC 27573-4573 | 2015-09-30 |
1942679519 | Urgent Cares of America North Carolina Inc | Non-Pharmacy Dispensing Site | 511 Smoky Park Hwy, Candler, NC 28715-8613 | 2015-09-24 |
1164891016 | Urgent Cares of America North Carolina Inc | Non-Pharmacy Dispensing Site | 212 N Spence Ave, Goldsboro, NC 27534-4318 | 2015-09-22 |
1811363674 | Unc Physicians Network, LLC | Non-Pharmacy Dispensing Site | 7100-9 Kit Creek Road, Research Triangle Park, NC 27709 | 2015-08-17 |
Find all providers with the same taxonomy |
City | FAYETTEVILLE |
Zip Code | 28304 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.