Organization
SATILLA CANCER TREATMENT CENTERS, LLC
Active
Other names
CurePoint
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JACQUELINE LILLICOTCH (CREDENTIALING OFFICER)
(478) 272-2255
Entity
Organization
Contact information
Practice address
1451 CHURCH ST, WAYCROSS, GA 31501-3531
(912) 283-3087
(912) 283-7337
Mailing address
1451 CHURCH ST, WAYCROSS, GA 31501-3531
(912) 283-3087
(912) 283-7337
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11D1096390
CLIA
GA
01
—
202G708768
MEDICARE PTAN
GA
05
—
300027669B
—
GA
01
—
DQ2362
RR MCR
GA
Enumeration date
05/17/2007
Last updated
10/19/2011
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