Organization
SATILLA CANCER TREATMENT CENTERS, LLC
Active
Other names
CurePoint
Organization subpart
No
Provider details
NPI number
Authorized official
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
1400 PETERSON AVE N, SUITE 10, DOUGLAS, GA 31533-2832
(912) 383-0815
(912) 383-0826
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
055248
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11D1096832
CLIA
GA
01
—
202G708768
MEDICARE PTAN
GA
05
—
300027669F
—
GA
01
—
DQ2362
RR MCR
GA
Enumeration date
03/05/2009
Last updated
10/19/2011
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