Organization
PROGRESSIVE CANCER CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN MUGHMAW (EXECUTIVE DIRECTOR)
(765) 662-4293
Entity
Organization
Contact information
Practice address
831 N THEATRE RD, MARION, IN 46952-1701
(765) 662-4293
Mailing address
PO BOX 1083, INDIANAPOLIS, IN 46206-1083
(317) 802-6318
(317) 870-0499
Taxonomy
Speciality
Code
Description
License number
State
261QX0203X
Radiation Oncology Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200507020
—
IN
Enumeration date
08/25/2006
Last updated
09/18/2014
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