Healthcare Provider Details

I. General information

NPI: 1710275433
Provider Name (Legal Business Name): GENESIS HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2011
Last Update Date: 07/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6040 HARFORD RD
BALTIMORE MD
21214-1327
US

IV. Provider business mailing address

8 FITZGERALD CT APT F
PARKVILLE MD
21234-2160
US

V. Phone/Fax

Practice location:
  • Phone: 410-426-8855
  • Fax:
Mailing address:
  • Phone: 443-562-1552
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number02003
License Number StateMD

VIII. Authorized Official

Name: MARGARET LYNN PRICE
Title or Position: STAFF OCCUPATIONAL THERAPIST
Credential: OTR/L
Phone: 410-426-8855