Healthcare Provider Details

I. General information

NPI: 1457807257
Provider Name (Legal Business Name): GENVENTURES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2016
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 S. COLLEGE AVENUE
ALEDO IL
61231-1630
US

IV. Provider business mailing address

101 S. COLLEGE AVENUE
ALEDO IL
61231-1630
US

V. Phone/Fax

Practice location:
  • Phone: 309-582-9345
  • Fax: 309-582-9349
Mailing address:
  • Phone: 309-582-9345
  • Fax: 309-582-9349

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MARK ROGERS
Title or Position: CFO
Credential:
Phone: 563-421-6513