1790921815 NPI number — SUASIN CANCER CARE INC.

Table of content: (NPI 1790921815)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790921815 NPI number — SUASIN CANCER CARE INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SUASIN CANCER CARE INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1790921815
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/18/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1300
Provider Second Line Business Mailing Address:
MAIL CODE 61105
Provider Business Mailing Address City Name:
HONOLULU
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96807-1300
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
512-583-0205
Provider Business Mailing Address Fax Number:
512-583-2001

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1301 PUNCHBOWL ST
Provider Second Line Business Practice Location Address:
NAEA TOWER, RADIATION ONCOLOGY DEPT.
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96813-2402
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-547-4771
Provider Business Practice Location Address Fax Number:
808-547-4570
Provider Enumeration Date:
12/18/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SUASIN
Authorized Official First Name:
WINLOVE
Authorized Official Middle Name:
B.
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
808-537-7143

Provider Taxonomy Codes

  • Taxonomy code: 2085R0001X , with the licence number:  223807-D1 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)