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General NPI Number Information
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NPI Number | 1639106180
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Entity Type | Organization
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Legal Business Name | GENESIS UNIVERSAL HEALTHCARE SERVICES INC.
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Dates
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Enumeration Date | 06/27/2006
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Last Update Date | 08/17/2018
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Provider Practice Location Address
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Address Line | 4199 DAVISON RD
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City | BURTON
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State | MI
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Zip | 48509-1403
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Country | US
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Telephone | 810-744-2331
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Fax |
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Provider Business Mailing Address
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Address Line | 2057 S LINDEN RD
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City | FLINT
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State | MI
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Zip | 48532-4160
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Country | US
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Telephone | 810-720-0104
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | BENSON EKONG
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Credential |
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Telephone | 810-720-0104
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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 |
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Taxonomy #2
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State |
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