Active NPI
Suburban Hematology Oncology Inc
- Hematology & Oncology Physician
- Beachwood, OH
National Provider Identifier
1942414412
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hematology & Oncology Physician
- License
- WI032845
- 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, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Alan Wine, M.D.
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0304585 | Medicaid | OH |
National Provider Directory
National Provider DirectoryLocations
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.
-
- Hematology & Oncology Physician
- Cleveland, OH
- NPI 1558325647
-
- Specialist
- Beachwood, OH
- NPI 1275638199
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.