MEDICARE: GENESIS FAMILY HEALTH CARE INC

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	HC1883	NC

General Provider Information

NPI Number	:	1720118672
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GENESIS FAMILY HEALTH CARE INC

Provider Business Mailing Address
First Line	:	1320 HAMILTON PLACE
Second Line	:	SUITE # 107
City	:	HIGH POINT
State	:	NC
Zip	:	27262
Country	:	US
Telephone Number	:	336-885-1830
Fax Number	:	336-885-1837

Provider Business Practice Location Address
First Line	:	1320 HAMILTON PLACE
Second Line	:	107
City	:	HIGH POINT
State	:	NC
Zip	:	27262-2600
Country	:	US
Telephone Number	:	336-885-1830
Fax Number	:	336-885-1837

Authorized Official
Title or Position	:	CHEIF EXECUTIVE OFFICER
Name	:	MR. JAMES E COLLINS
Credential	:
Telephone Number	:	336-885-1830

Provider Enumeration Date	:	03/07/2007
Last Update Date	:	09/21/2007

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