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NPI Code Detail

MEDICARE: GENESIS HEALTHCARE

MEDICARE: GENESIS HEALTHCARE
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
1313M00000XNursing Facility/Intermediate Care FacilityOTA 02070OH

General Provider Information

NPI Number : 1568584928
Entity Type Code : Organization
Provider Name (Legal Business Name) : GENESIS HEALTHCARE
Provider Business Mailing Address
First Line : 536 UNGER AVE
Second Line :
City : ENGLEWOOD
State : OH
Zip : 45322-2027
Country : US
Telephone Number : 937-832-3250
Fax Number :
Provider Business Practice Location Address
First Line : 1390 KING TREE DR
Second Line :
City : DAYTON
State : OH
Zip : 45405-1401
Country : US
Telephone Number : 937-278-0723
Fax Number : 937-276-8675
Authorized Official
Title or Position : THERAPY MGR
Name : MELINDA JACOBS
Credential :
Telephone Number : 937-829-9056
Provider Enumeration Date : 04/05/2007
Last Update Date : 07/27/2009

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Directions to “GENESIS HEALTHCARE ” Practice Location

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