MEDICARE: GEORGE ZHANG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	03237344	OH

General Provider Information

NPI Number	:	1578169595
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GEORGE ZHANG

Provider Business Mailing Address
First Line	:	1411 LEXINGTON AVE
Second Line	:
City	:	MANSFIELD
State	:	OH
Zip	:	44907-2629
Country	:	US
Telephone Number	:	419-756-1321
Fax Number	:

Provider Business Practice Location Address
First Line	:	1411 LEXINGTON AVE
Second Line	:
City	:	MANSFIELD
State	:	OH
Zip	:	44907-2629
Country	:	US
Telephone Number	:	419-756-1321
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/06/2020
Last Update Date	:	12/06/2020

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Directions to “ GEORGE ZHANG ” Practice Location

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