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General NPI Number Information
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NPI Number | 1417908690
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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 | 05/13/2006
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Last Update Date | 08/27/2008
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Provider Practice Location Address
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Address Line | 611 N 2ND ST
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City | CLINTON
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State | IA
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Zip | 52732-3839
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Country | US
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Telephone | 563-242-7165
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Fax | 563-242-7197
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Provider Business Mailing Address
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Address Line | 611 N 2ND ST
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City | CLINTON
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State | IA
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Zip | 52732-3839
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Country | US
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Telephone | 563-242-7165
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Fax | 563-242-7197
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Authorized Official
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Title or Position | PRESIDENT AND CEO
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Name | MR. DOUG P. CROPPER
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Credential |
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Telephone | 563-421-6510
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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