Organization
COMMUNITY CANCER FOUNDATION
Active
Organization
COMMUNITY CANCER FOUNDATION
Active
Other names
Community Cancer Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TAMMY HAGEDORN (EXECUTIVE DIRECTOR)
(541) 673-2267
Entity
Organization
Contact information
Practice address
2880 NW STEWART PKWY, SUITE 100, ROSEBURG, OR 97471-1201
(541) 673-2267
(541) 672-9483
Mailing address
2880 NW STEWART PKWY, SUITE 100, ROSEBURG, OR 97471-1201
(541) 673-2267
(541) 672-9483
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
—
—
261Q00000X
Clinic/Center
—
—
261QX0203X
Radiation Oncology Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000773
—
OR
01
—
002524000
REGENCE BCBS OF OREGON
OR
01
—
4308388
REGENCE BCBS PC65
OR
Enumeration date
07/27/2005
Last updated
02/03/2020
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