MEDICARE: GENESIS PARTNERS II

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
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1568175347
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GENESIS PARTNERS II

Provider Business Mailing Address
First Line	:	324 N 48TH ST
Second Line	:
City	:	SPRINGDALE
State	:	AR
Zip	:	72762-3746
Country	:	US
Telephone Number	:	479-246-0140
Fax Number	:

Provider Business Practice Location Address
First Line	:	108 E STEPHENSON AVE STE C
Second Line	:
City	:	HARRISON
State	:	AR
Zip	:	72601-4312
Country	:	US
Telephone Number	:	870-751-7512
Fax Number	:

Authorized Official
Title or Position	:	COO
Name	:	CODY GARRISON
Credential	:
Telephone Number	:	870-404-9300

Provider Enumeration Date	:	12/27/2022
Last Update Date	:	12/27/2022

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Directions to “GENESIS PARTNERS II ” Practice Location

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