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Contact Information

CHARLESTON RADIATION THERAPY CONSULTANTS PLLC
3415 MACCORKLE AVE SE
CHARLESTON, WV25304
 Phone: 304-388-1790
 Fax: 304-388-1768
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Radiation Oncology

2085R0001X 92 Physician/Radiation Oncology
 

Specialist

174400000X
Indicates primary specialty

NPI Profile & details for CHARLESTON RADIATION THERAPY CONSULTANTS PLLC

NPI # 1942208145
LBN Legal business name CHARLESTON RADIATION THERAPY CONSULTANTS PLLC
Authorized official REBECCA HORTON - (PROVIDER ENROLLMENT COORDINATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 07/12/2005
Last updated 07/21/2022 - About 4 years ago
Identifiers
WV License # 001
WV Medicaid 0007557000
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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