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General NPI Number Information
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NPI Number | 1568406338
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Entity Type | Organization
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Legal Business Name | GENIC HEALTHCARE SERVICES AND SUPPLY, INC
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Dates
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Enumeration Date | 06/15/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9914 DERBY LN
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City | WESTCHESTER
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State | IL
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Zip | 60154-3719
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Country | US
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Telephone | 708-344-8130
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Fax |
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Provider Business Mailing Address
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Address Line | 9914 DERBY LN
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City | WESTCHESTER
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State | IL
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Zip | 60154-3768
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Country | US
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Telephone | 708-344-8130
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | TONY WOODS
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Credential |
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Telephone | 708-344-8130
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State | IL
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