Healthcare Provider Details

I. General information

NPI: 1649368523
Provider Name (Legal Business Name): GENESIS HEALTH SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1118 11TH ST
DE WITT IA
52742-1235
US

IV. Provider business mailing address

1118 11TH ST
DE WITT IA
52742-1353
US

V. Phone/Fax

Practice location:
  • Phone: 563-659-4200
  • Fax: 563-659-4223
Mailing address:
  • Phone: 563-659-4200
  • Fax: 563-659-4223

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State

VIII. Authorized Official

Name: EDWARD ROGALSKI
Title or Position: ADMINISTRATOR
Credential:
Phone: 563-659-4220