MEDICARE: GENESIS HEALTHCARE SYSTEM

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	332B00000X	Durable Medical Equipment & Medical Supplies
2	3336C0003X	Community/Retail Pharmacy	02-707700	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0232000344	OTHER	OH	STATE LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1861449043
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GENESIS HEALTHCARE SYSTEM

Provider Business Mailing Address
First Line	:	133 N MAYSVILLE AVE
Second Line	:
City	:	ZANESVILLE
State	:	OH
Zip	:	43701-6112
Country	:	US
Telephone Number	:	740-454-5666
Fax Number	:	740-452-7563

Provider Business Practice Location Address
First Line	:	157 S MAIN ST
Second Line	:
City	:	ROSEVILLE
State	:	OH
Zip	:	43777-1238
Country	:	US
Telephone Number	:	740-697-0348
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	MICHAEL NORMAN
Credential	:
Telephone Number	:	740-454-4773

Provider Enumeration Date	:	05/31/2006
Last Update Date	:	09/11/2023

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