=====================================================
General NPI Number Information
=====================================================
NPI Number | 1568757334
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GENESYS HEALTH ENTERPRISES, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/09/2011
-----------------------------------------------------
Last Update Date | 07/22/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8220 S. SAGINAW SUITE 1000
-----------------------------------------------------
City | GRAND BLANC
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48439
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 810-694-4391
-----------------------------------------------------
Fax | 810-694-4674
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1000 HEALTH PARK BLVD SUITE B
-----------------------------------------------------
City | GRAND BLANC
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48439-9936
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 810-603-8900
-----------------------------------------------------
Fax | 810-606-5255
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | DEBORAH G. HOLMAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 810-606-7282
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------