Vantage Cancer Care - Alabama, LLC

Primary specialty

Medical Oncology PhysicianTaxonomy code 207RX0202X

Legal business name

VANTAGE CANCER CARE - ALABAMA, LLC

Practice address

29653 Anchor Cross Blvd
Daphne, AL 36526-9594

Phone

(251) 626-1755

NPI assigned

Sep 17, 2014

Organization subpart

Yes

Parent organization

VANTAGE CANCER CARE NETWORKS, LLCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Steven Udicious, ESQUIRE

Title

Vice President, General Counsel

Phone

(610) 519-0550

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1410912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413331200000",
    "number": "1669874004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 ROSECRANS AVE",
            "address_2": "SUITE 400",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902663763",
            "telephone_number": "310-335-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29653 ANCHOR CROSS BLVD",
            "city": "DAPHNE",
            "state": "AL",
            "postal_code": "365269594",
            "telephone_number": "251-626-1755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANTAGE CANCER CARE - ALABAMA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VANTAGE CANCER CARE NETWORKS, LLC",
        "enumeration_date": "2014-09-17",
        "last_updated": "2014-10-15",
        "status": "A",
        "authorized_official_last_name": "UDICIOUS",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "VICE PRESIDENT, GENERAL COUNSEL",
        "authorized_official_telephone_number": "610-519-0550",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ESQUIRE"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Medical Oncology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• University of South Alabama Health Care Authority
• Urgent Care by the Bay, LLC
• Chrysthian Ivan Uribe Avalos
• John Gayle Van Derwood, M.D.
• Patricia A Vanderpool, MS, LPC, CEAP, SAP
• Vantage Cancer Care Network of Alabama, LLC
• Tyler Berton Vaughn, PT, DPT
• Annie Velotas, PT
• Nicholas Vester, PA-C
• Vida Screening LLC

• Medical Oncology Physician in Daphne, AL
• Providers in Daphne, AL by specialty
• Medical Oncology Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.