Organization
CENTRAL CARE PA
Active
Other names
CENTRAL CARE CANCER CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
CANDICE EVANS (CREDENTIALING)
(620) 603-8846
Entity
Organization
Contact information
Practice address
1501 N OAKLAND AVE, BOLIVAR, MO 65613-3020
(417) 326-7200
(417) 326-7201
Mailing address
PO BOX 256, SALINA, KS 67402-0256
(785) 823-0633
(785) 823-0658
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
—
—
2085R0001X
Radiation Oncology Physician
—
—
332900000X
Non-Pharmacy Dispensing Site
Primary
002905
MO
Other
Enumeration date
09/12/2013
Last updated
04/02/2024
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