Organization · NPI-2

2406 Cancer Care LLC

· Dublin, GA

NPI number1619682515
StatusActive
Last updated in NPPESDec 3, 2025

Details

NPI
1619682515
Entity type
Organization (NPI-2)
Legal business name
2406 Cancer Care LLC
Organization subpart
No
Enumeration date
Jan 16, 2023
Certification date
Dec 3, 2025
Last updated
Dec 3, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2085R0001X ––Yes

Practice location

2406 Bellevue Rd Ste 7
Dublin, GA 31021-2842

Phone 478-272-2255

Mailing address

Po Box 96465
Charlotte, NC 28296-0465

Phone 478-272-2255

Authorized official

Erich Graham Randolph
Authorized Official
4042346473

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