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NPI Code Detail

MEDICARE: GENESIS HEALTH SYSTEM

MEDICARE: GENESIS HEALTH SYSTEM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1073629473
Entity Type Code : Organization
Provider Name (Legal Business Name) : GENESIS HEALTH SYSTEM
Provider Business Mailing Address
First Line : 865 LINCOLN RD
Second Line : STE L10
City : BETTENDORF
State : IA
Zip : 52722-4190
Country : US
Telephone Number : 563-355-9191
Fax Number : 563-355-3419
Provider Business Practice Location Address
First Line : 306 46TH AVE
Second Line :
City : EAST MOLINE
State : IL
Zip : 61244-4281
Country : US
Telephone Number : 309-792-2329
Fax Number : 309-792-1146
Authorized Official
Title or Position : VICE PRESIDENT OF FINANCE
Name : MR. MARK J KLEINSCHMIDTE
Credential :
Telephone Number : 563-421-6513
Provider Enumeration Date : 08/21/2006
Last Update Date : 08/22/2020

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Directions to “GENESIS HEALTH SYSTEM ” Practice Location

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