LOW COUNTRY CANCER CARE (NPI# 1386669240) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386669240 |
| Entity Type | Organization |
| Organization Name | LOW COUNTRY CANCER CARE |
| Practice Address |
225 Candler Rd Suite 201 Savannah GA 31405-6023 |
| Practice Telephone | 9126922000 |
| Practice Fax Number | 9126922100 |
| Mailing Telephone | 9126922000 |
| Mailing Fax Number | 9126922100 |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2020-03-10 |
| Authorized Official Name | LOERA MARIA RENDON DE VALLIER (OPERATIONS MANAGER) |
| Authorized Official Telephone | 9126922000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000489233E | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 101 St Josephs Candler Dr Ste 340, Pooler, GA 313229588 | 9126922000 | 9126922100 |
| 12 Arley Way Ste 101b, Bluffton, SC 299108860 | 9126922000 | 9126922100 |
| 229 W General Screven Way Ste H1, Hinesville, GA 313133054 | 9126922000 | 9126922100 |
| Street Address |
225 CANDLER RD SUITE 201 |
| City | SAVANNAH |
| State | GA |
| Zip Code | 31405-6023 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831237148 | John A Pablo | Radiology | 225 Candler Rd, Suite 100, Savannah, GA 31405-6023 | 2007-02-01 |
| 1588702872 | Morris Roy Geffen | Radiology | 225 Candler Rd, Suite 100, Savannah, GA 31405-6023 | 2007-02-01 |
| 1568518504 | Cancer Care Pavilion, Inc. | Surgery | 225 Candler Rd, Suite 204, Savannah, GA 31405-6023 | 2007-01-25 |
| 1154404242 | Renewal, Inc | Durable Medical Equipment & Medical Supplies | 225 Candler Rd, Suite 102, Savannah, GA 31405-6023 | 2006-10-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053918441 | Nicole Marie Tetro | Anesthesiology | Candler Hospital, 5353 Reynolds St, Savannah, GA 31405 | 2020-10-08 |
| 1154983880 | Nickes Medical Supply, LLC. | Durable Medical Equipment & Medical Supplies | 6020 Halsey St, Savannah, GA 31405 | 2019-07-02 |
| 1215593025 | Lee Ann Ryle | Nurse Practitioner | 5223 Paulsen St., Savannah, GA 31405 | 2019-05-16 |
| 1942765334 | Raegan Epps | Behavior Technician | 613 Stephenson Ave Ste 205, Savannah, GA 31405 | 2019-02-10 |
| 1679050454 | Phenomenal Nursing Service | Registered Nurse | 604 South St., 604 South St, Savannah, GA 31405 | 2018-07-24 |
| 1275029472 | Chelsea Amanda Keedy | Pharmacist | 836 E. 65th St., Medical Arts #4, Savannah, GA 31405 | 2018-07-11 |
| 1265933840 | Dwc-p LLC | Dentist | 5209 Paulsen Street, Savannah, GA 31405 | 2018-02-28 |
| 1386153005 | Aaron Shaw | Hearing Instrument Specialist | 5501 Abercorn St Ste E, Savannah, GA 31405 | 2017-09-26 |
| 1063946028 | Elizabeth Bentley Bruhn-danello | Dietitian, Registered | 836 East 65th Street, Medical Arts #4, Savannah, GA 31405 | 2017-04-17 |
| 1396278230 | Theresa Lynn George | Health Educator | 836 East 65 Th Street, Medical Arts #4, Savannah, GA 31405 | 2017-04-07 |
| Find all providers in zip 31405 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902810500 | Lester E. Robertson | Internal Medicine | 4700 Waters Ave Ste A, Suite A, Savannah, GA 31404 | 2006-07-28 |
| 1003217712 | Candler Medical Oncology Practice, LLC | Internal Medicine | 225 Candler Dr, Ste 300, Savannah, GA 31405-6023 | 2014-09-12 |
| 1750590931 | Christopher Emil Haberman | Internal Medicine | 4700 Waters Ave, Suite A, Savannah, GA 31404 | 2007-05-22 |
| 1215009287 | Grant Carlton Lewis | Internal Medicine | 225 Candler Dr, Suite 300, Savannah, GA 31405-6023 | 2006-11-15 |
| 1962416891 | Harvey C. Lebos | Internal Medicine | 4700 Waters Ave, Suite A, Savannah, GA 31404-6220 | 2006-07-28 |
| 1548274004 | Barry D. Luskey | Internal Medicine | 4700 Waters Ave, Suite A, Savannah, GA 31404 | 2006-07-28 |
| 1326052085 | Mark A. Taylor | Internal Medicine | 225 Candler Dr, Suite 300, Savannah, GA 31405 | 2006-07-28 |
| 1417971649 | Ronald F. Goldberg | Internal Medicine | 225 Candler Dr, Suite 300, Savannah, GA 31405 | 2006-07-27 |
| 1881617157 | Ayer Bala | Internal Medicine | 225 Candler Dr, Suite 300, Savannah, GA 31405-6023 | 2006-07-26 |
| 1487676433 | Summit Cancer Care, P.C. | Internal Medicine | 4700 Waters Ave, Savannah, GA 31404-6220 | 2006-07-25 |
| Find all providers in SAVANNAH | ||||
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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.