Organization Active NPI

Suburban Hematology Oncology Inc

  • Hematology & Oncology Physician
  • Beachwood, OH
National Provider Identifier
1942414412
Registry record updated Oct 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
WI032845 Issued in OH
Legal business name
SUBURBAN HEMATOLOGY ONCOLOGY INC
Practice address
3619 Park East Dr
Suite 211
Beachwood, OH 44122-4330
Phone
(216) 378-0900
Fax
(216) 378-1853
NPI assigned
May 10, 2007
Last updated
Oct 25, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2007

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

Authorized official

Name
Dr. Alan Wine, M.D.NPI 1558325647
Title
Owner
Phone
(216) 378-0900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X WI032845 OH Primary

Addresses

Primary practice location

3619 Park East Dr
Suite 211
Beachwood, OH 44122-4330

Mailing address

6463 Taylor Mill Rd
Independence, KY 41051-9392
Phone (859) 363-4900

Other identifiers 1

IdentifierTypeStateIssuer
0304585MedicaidOH

National Provider Directory

National Provider Directory

Locations

3619 Park East Dr
Ste 211
Cleveland, OH 44122
Phone (216) 378-0900

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193270400000",
    "number": "1942414412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6463 TAYLOR MILL RD",
            "city": "INDEPENDENCE",
            "state": "KY",
            "postal_code": "410519392",
            "telephone_number": "859-363-4900",
            "fax_number": "859-363-4986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3619 PARK EAST DR",
            "address_2": "SUITE 211",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441224330",
            "telephone_number": "216-378-0900",
            "fax_number": "216-378-1853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUBURBAN HEMATOLOGY ONCOLOGY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-10",
        "last_updated": "2007-10-25",
        "status": "A",
        "authorized_official_last_name": "WINE",
        "authorized_official_first_name": "ALAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "216-378-0900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "OH",
            "license": "WI032845",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0304585",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beachwood, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2007; 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.