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General NPI Number Information
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NPI Number | 1609000488
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Entity Type | Organization
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Legal Business Name | GENASSIST INC
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Dates
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Enumeration Date | 05/08/2009
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Last Update Date | 06/03/2009
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Provider Practice Location Address
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Address Line | 8101 E BELLEVIEW AVE SUITE J
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City | DENVER
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State | CO
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Zip | 80237-2903
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Country | US
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Telephone | 818-441-1664
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Fax |
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Provider Business Mailing Address
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Address Line | 1153 BERGEN PKWY SUITE M-451
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City | EVERGREEN
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State | CO
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Zip | 80439-9501
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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 | MANAGER
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Name | ROBERT VITALI
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Credential |
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Telephone | 818-441-1664
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 06D0510759
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License Number State | CO
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