Healthcare Provider Details

I. General information

NPI: 1861449043
Provider Name (Legal Business Name): GENESIS HEALTHCARE SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2006
Last Update Date: 09/11/2023
Certification Date: 09/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

157 S MAIN ST
ROSEVILLE OH
43777-1238
US

IV. Provider business mailing address

133 N MAYSVILLE AVE
ZANESVILLE OH
43701-6112
US

V. Phone/Fax

Practice location:
  • Phone: 740-697-0348
  • Fax:
Mailing address:
  • Phone: 740-454-5666
  • Fax: 740-452-7563

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number02-707700
License Number StateOH

VIII. Authorized Official

Name: MICHAEL NORMAN
Title or Position: CFO
Credential:
Phone: 740-454-4773