Provider Demographics
NPI: | 1265636229 |
---|---|
Name: | HANKOOK MEDICAL CENTER INC |
Entity Type: | Organization |
Organization Name: | HANKOOK MEDICAL CENTER INC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | |
Authorized Official - First Name: | EUN |
Authorized Official - Middle Name: | H |
Authorized Official - Last Name: | LEE |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 703-642-1004 |
Mailing Address - Street 1: | 7535 LITTLE RIVER TPKE |
Mailing Address - Street 2: | SUITE 206 |
Mailing Address - City: | ANNANDALE |
Mailing Address - State: | VA |
Mailing Address - Zip Code: | 22003-2937 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 7535 LITTLE RIVER TPKE |
Practice Address - Street 2: | SUITE 206 |
Practice Address - City: | ANNANDALE |
Practice Address - State: | VA |
Practice Address - Zip Code: | 22003-2937 |
Practice Address - Country: | US |
Practice Address - Phone: | 703-642-1004 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2007-06-13 |
Last Update Date: | 2020-08-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
VA | 0101233152 | 207R00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty |