Organization
THE REGIONAL CANCER CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN GIRARD (DIRECTOR OF OPERATIONS)
(814) 836-2604
Entity
Organization
Contact information
Practice address
2500 W 12TH ST, ERIE, PA 16505
(814) 836-2651
(814) 838-0443
Mailing address
2500 W 12TH ST, ERIE, PA 16505
(814) 836-2651
(814) 838-0443
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
—
PA
207RX0202X
Medical Oncology Physician
—
—
2085R0001X
Radiation Oncology Physician
—
PA
2085R0001X
Radiation Oncology Physician
—
—
3336C0002X
Clinic Pharmacy
BR1627768
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017638630005
—
PA
01
—
105863
UPMC
PA
01
—
127683
MED PLUSH
—
01
—
3956945
NCPDP
PA
01
—
991590
B CROSS
PA
Enumeration date
07/08/2005
Last updated
07/21/2022
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