2406 Cancer Care LLC

Organization Active NPI Radiation Oncology Physician · Dublin, GA

NPI 1619682515 · NPPES record last updated Dec 3, 2025

Key facts

NPI
1619682515
Entity type
Organization (NPI type 2)
Primary specialty
Radiation Oncology Physician 2085R0001X
Legal business name
2406 CANCER CARE LLC
Practice address
2406 Bellevue Rd Ste 7
Dublin, GA 31021-2842
Phone
(478) 272-2255
NPI assigned
Jan 16, 2023
Organization subpart
No

Authorized official

Name
Erich Graham Randolph
Title
Authorized Official
Phone
(404) 234-6473

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in GA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20230210000198 GA Part B Supplier - Clinic/Group Practice 7719359249 Receives reassigned benefits from 3 practitioners
1 other NPI on this enrollment
Practice locations: Dublin, GA

National Provider Directory

Tax ID family
2406 Cancer Care LLC (2 organizations share this tax ID)

Locations

2406 Bellevue Rd
Ste 7
Dublin, GA 31021
Phone (478) 272-2255

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician
Group: 193400000X SINGLE SPECIALTY GROUP
2085R0001X Yes

Addresses

Primary practice location

2406 Bellevue Rd Ste 7
Dublin, GA 31021-2842

Mailing address

PO Box 96465
Charlotte, NC 28296-0465
Phone (478) 272-2255

Other providers in Dublin, GA

All providers in Dublin, GA · Radiation Oncology Physician in Georgia

Sources for this page

Verify at the official NPI Registry.