Healthcare Provider Details

I. General information

NPI: 1295661650
Provider Name (Legal Business Name): GENMEDCO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5011 GATE PKWY STE 100
JACKSONVILLE FL
32256-0830
US

IV. Provider business mailing address

3948 3RD ST S STE 23
JACKSONVILLE BEACH FL
32250-5847
US

V. Phone/Fax

Practice location:
  • Phone: 626-796-1051
  • Fax: 626-796-7298
Mailing address:
  • Phone: 626-796-1051
  • Fax: 626-796-7298

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MS. EMMA Y STEWART
Title or Position: MANAGING MEMBER
Credential:
Phone: 626-720-7456