Provider Demographics
NPI:1174637409
Name:ZEBULON HEALTHCARE CENTER PA
Entity Type:Organization
Organization Name:ZEBULON HEALTHCARE CENTER PA
Other - Org Name:YINNAN HWANG MD
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:YINNAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HWANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-269-4101
Mailing Address - Street 1:PO BOX 425
Mailing Address - Street 2:1303 WATER PLANT RD.
Mailing Address - City:ZEBULON
Mailing Address - State:NC
Mailing Address - Zip Code:27597-0425
Mailing Address - Country:US
Mailing Address - Phone:919-269-4101
Mailing Address - Fax:919-269-8811
Practice Address - Street 1:1303 WATER PLANT RD.
Practice Address - Street 2:
Practice Address - City:ZEBULON
Practice Address - State:NC
Practice Address - Zip Code:27597-0425
Practice Address - Country:US
Practice Address - Phone:919-269-4101
Practice Address - Fax:919-269-8811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC74082208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890221JMedicaid
NC8945179Medicaid
203505Medicare PIN
D33057Medicare UPIN