Healthcare Provider Details

I. General information

NPI: 1457709289
Provider Name (Legal Business Name): GENESYS SURGERY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2016
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36622 FIVE MILE RD STE 201
LIVONIA MI
48154-1900
US

IV. Provider business mailing address

500 STEPHENSON HWY STE 300
TROY MI
48083-1118
US

V. Phone/Fax

Practice location:
  • Phone: 734-351-5272
  • Fax:
Mailing address:
  • Phone: 586-439-6258
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KATHRYN MARY PRING
Title or Position: VICE-PRESIDENT OF OPERATIONS
Credential:
Phone: 586-439-6314