# SSM CANCER CARE, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SSM Health Cancer Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1487963179
- **Authorized official:** MR. ELLIS HAWKINS (PRESIDENT)
- **Authorized official phone:** (636) 496-2500

## Contact information

- **Practice address:** 400 MEDICAL PLZ, SUITE 100, LAKE SAINT LOUIS, MO 63367-1490
- **Practice address phone:** (636) 639-8600
- **Practice address fax:** (636) 639-8676
- **Mailing address:** 400 MEDICAL PLZ, SUITE 100, LAKE SAINT LOUIS, MO 63367-1490
- **Mailing address phone:** (636) 639-8600
- **Mailing address fax:** (636) 639-8676

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RH0003X | Hematology & Oncology Physician | — | NULL | Yes |
| 207RH0003X | Hematology & Oncology Physician | — | — | Yes |
| 2085R0001X | Radiation Oncology Physician | — | NULL | — |
| 2085R0001X | Radiation Oncology Physician | — | — | — |

## Other

- **Enumeration date:** 09/29/2010
- **Last updated:** 01/25/2016