Healthcare Provider Details
I. General information
NPI: 1447461066
Provider Name (Legal Business Name): GENESYS HEALTH ENTERPRISES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/25/2007
Last Update Date: 11/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3909 BEECHER RD
FLINT MI
48532-3602
US
IV. Provider business mailing address
3909 BEECHER RD
FLINT MI
48532-3602
US
V. Phone/Fax
- Phone: 810-762-3662
- Fax:
- Phone: 810-762-3662
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
LARRY
D
BROTHERS
Title or Position: PRESIDENT
Credential:
Phone: 810-762-3662