Provider Demographics
NPI:1699089953
Name:SUASIN CANCER CARE, INC.
Entity type:Organization
Organization Name:SUASIN CANCER CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RADIATION ONCOLOGIST/MEDICAL DIRECT
Authorized Official - Prefix:
Authorized Official - First Name:WINLOVE
Authorized Official - Middle Name:B
Authorized Official - Last Name:SUASIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:276-596-6010
Mailing Address - Street 1:P.O. BOX 816
Mailing Address - Street 2:
Mailing Address - City:RICHLANDS
Mailing Address - State:VA
Mailing Address - Zip Code:24641
Mailing Address - Country:US
Mailing Address - Phone:276-596-6010
Mailing Address - Fax:276-596-6019
Practice Address - Street 1:6801 GOV.G.C. PEERY HWY
Practice Address - Street 2:
Practice Address - City:RICHLANDS
Practice Address - State:VA
Practice Address - Zip Code:24641
Practice Address - Country:US
Practice Address - Phone:276-596-6010
Practice Address - Fax:276-596-6019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-28
Last Update Date:2011-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012479552085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty