Provider Demographics
NPI:1366093817
Name:ZEBULON OPCO, LLC
Entity type:Organization
Organization Name:ZEBULON OPCO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:BUNN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-322-5535
Mailing Address - Street 1:1205 W GANNON AVE
Mailing Address - Street 2:
Mailing Address - City:ZEBULON
Mailing Address - State:NC
Mailing Address - Zip Code:27597-8838
Mailing Address - Country:US
Mailing Address - Phone:919-269-7762
Mailing Address - Fax:
Practice Address - Street 1:1205 W GANNON AVE
Practice Address - Street 2:
Practice Address - City:ZEBULON
Practice Address - State:NC
Practice Address - Zip Code:27597-8838
Practice Address - Country:US
Practice Address - Phone:919-269-7762
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-26
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)