Healthcare Provider Details

I. General information

NPI: 1578755849
Provider Name (Legal Business Name): GENESYS HEALTH ENTERPRISES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2007
Last Update Date: 11/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 N FENWAY DR SUITE C
FENTON MI
48430-3810
US

IV. Provider business mailing address

425 N FENWAY DR SUITE C
FENTON MI
48430-3810
US

V. Phone/Fax

Practice location:
  • Phone: 810-750-5450
  • Fax:
Mailing address:
  • Phone: 810-750-5450
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. ROBERT K STEVENS
Title or Position: VICE PRESIDENT OF COC
Credential:
Phone: 810-762-3662