MEDICARE: GENERATIONS R.C., INC.

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	225100000X	Physical Therapist

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	CN7183	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1707207	OTHER	WV	BLUE CROSS BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144384421
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GENERATIONS R.C., INC.

Provider Business Mailing Address
First Line	:	PO BOX 687
Second Line	:
City	:	GREENUP
State	:	KY
Zip	:	41144-0687
Country	:	US
Telephone Number	:	606-473-1080
Fax Number	:	606-473-5875

Provider Business Practice Location Address
First Line	:	3705 TEAYS VALLEY RD
Second Line	:	SUITE 100
City	:	HURRICANE
State	:	WV
Zip	:	25526-9645
Country	:	US
Telephone Number	:	304-757-2500
Fax Number	:	304-757-2586

Authorized Official
Title or Position	:	EXECUTIVE VP - BUSINESS OPERATIONS
Name	:	MRS. DELORIS S BENTLEY
Credential	:
Telephone Number	:	606-473-1080

Provider Enumeration Date	:	12/20/2006
Last Update Date	:	04/20/2008

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Directions to “GENERATIONS R.C., INC. ” Practice Location

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