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General NPI Number Information
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NPI Number | 1336532936
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Entity Type | Organization
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Legal Business Name | GENESIS HEALTHCARE
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Dates
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Enumeration Date | 03/06/2015
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Last Update Date | 03/06/2015
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Provider Practice Location Address
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Address Line | 4783 FRUITVILLE RD
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City | SARASOTA
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State | FL
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Zip | 34232-1815
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Country | US
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Telephone | 941-378-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 4783 FRUITVILLE RD
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City | SARASOTA
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State | FL
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Zip | 34232-1815
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF REHAB
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Name | MARYELLEN PELLMAN
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Credential |
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Telephone | 941-312-4243
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | OTA11955
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License Number State | FL
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