Provider Demographics
NPI:1043356686
Name:CROWN HEALTH CARE, PA
Entity Type:Organization
Organization Name:CROWN HEALTH CARE, PA
Other - Org Name:GENERATIONS FAMILY MEDICINE & AESTHETICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-465-9293
Mailing Address - Street 1:212 29TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-1130
Mailing Address - Country:US
Mailing Address - Phone:828-485-2762
Mailing Address - Fax:
Practice Address - Street 1:212 29TH AVE NE
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-1130
Practice Address - Country:US
Practice Address - Phone:828-485-2762
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2007-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCCN8132OtherMEDICARE RAILROAD