Healthcare Provider Details

I. General information

NPI: 1811141781
Provider Name (Legal Business Name): GENESIS HEALTHCARE SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2008
Last Update Date: 02/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2951 MAPLE AVE
ZANESVILLE OH
43701-1406
US

IV. Provider business mailing address

2951 MAPLE AVE
ZANESVILLE OH
43701-1406
US

V. Phone/Fax

Practice location:
  • Phone: 740-586-6610
  • Fax: 740-586-6665
Mailing address:
  • Phone: 740-586-6626
  • Fax: 740-450-6273

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number36D0332826
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number36D0665877
License Number StateOH

VIII. Authorized Official

Name: MR. MICHAEL NORMAN
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 740-454-4773