Organization
SJC ONCOLOGY SERVICES-SOUTH CAROLINA, LLC
Active
Other names
Beaufort Hilton Head Radiation Oncology Center, LP
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREGORY J SCHAACK (CFO/VP, FINANCE)
(912) 819-6162
Entity
Organization
Contact information
Practice address
100 BUCKWALTER PLACE BLVD STE 150, BLUFFTON, SC 29910-5154
(843) 836-7120
(843) 836-7137
Mailing address
PO BOX 11407, DEPT 1623, BIRMINGHAM, AL 35246-1623
(912) 352-1700
(912) 352-1066
Taxonomy
Speciality
Code
Description
License number
State
207VX0201X
Gynecologic Oncology Physician
—
—
2085R0001X
Radiation Oncology Physician
Primary
—
—
2086X0206X
Surgical Oncology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000360533A
—
GA
05
—
114450
—
SC
01
—
CC0817
RAILROAD MEDICARE
SC
05
—
GP5359
—
SC
Enumeration date
05/21/2007
Last updated
03/09/2020
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