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General NPI Number Information
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NPI Number | 1013968262
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Entity Type | Organization
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Legal Business Name | GENESIS HEALTH SYSTEM
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Dates
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Enumeration Date | 05/12/2006
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Last Update Date | 07/12/2024
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Provider Practice Location Address
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Address Line | 2546 TECH DR
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City | BETTENDORF
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State | IA
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Zip | 52722-3345
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Country | US
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Telephone | 563-421-5400
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Fax |
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Provider Business Mailing Address
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Address Line | 2535 MAPLECREST RD SUITE 4
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City | BETTENDORF
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State | IA
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Zip | 52722-7709
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Country | US
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Telephone | 563-421-5400
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | JOSEPH D MALAS
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Credential |
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Telephone | 563-421-6508
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 2002574
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License Number State | IL
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