Provider Demographics
NPI:1932737970
Name:ZION MEDICAL LLC
Entity Type:Organization
Organization Name:ZION MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH-JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:NGONGBO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-887-7758
Mailing Address - Street 1:9429 MIRROR POND DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22032-1352
Mailing Address - Country:US
Mailing Address - Phone:703-887-7758
Mailing Address - Fax:
Practice Address - Street 1:7100 COLUMBIA PIKE
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-3106
Practice Address - Country:US
Practice Address - Phone:703-634-3180
Practice Address - Fax:855-910-0802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-27
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No385H00000XRespite Care FacilityRespite Care