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General NPI Number Information
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NPI Number | 1366746430
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Entity Type | Organization
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Legal Business Name | GENESIS GLOBAL NETWORK
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Dates
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Enumeration Date | 01/05/2011
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Last Update Date | 10/19/2011
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Provider Practice Location Address
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Address Line | 10515 W MARKHAM ST # H8
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City | LITTLE ROCK
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State | AR
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Zip | 72205-2139
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Country | US
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Telephone | 501-626-6090
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Fax |
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Provider Business Mailing Address
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Address Line | 10515 W MARKHAM ST # H8
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City | LITTLE ROCK
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State | AR
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Zip | 72205-2139
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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 | PRESIDENT
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Name | MS. VERLIEA WATSON
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Credential |
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Telephone | 501-626-6090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | BL00096923
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number | 00000000
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License Number State | AR
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Taxonomy #3
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | BL00096923
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License Number State | AR
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