MEDICARE: GENESIS FAMILY HEALTHCARE, 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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1720118672	OTHER	NC	NPI

General Provider Information

NPI Number	:	1821284936
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GENESIS FAMILY HEALTHCARE, INC

Provider Business Mailing Address
First Line	:	4404 NATURAL LAKE CT
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27410-9156
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1320 N HAMILTON ST
Second Line	:	SUITE 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	:	CEO
Name	:	MR. JAMES EARL COLLINS
Credential	:
Telephone Number	:	336-885-1830

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

Similar Medicare Providers

1720118672 — GENESIS FAMILY HEALTH CARE INC
Practice Location Address:

1320 HAMILTON PLACE , 107
HIGH POINT, NC
27262-2600

Practice Phone: 336-885-1830
Practice Fax: 336-885-1837

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HIGH POINT, NC
27262-2600

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1366673048 — DR. PHILIP ASENSO M.D.
Practice Location Address:

1320 N HAMILTON ST
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27262-2600

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1205268554 — MRS. JANE STEWART JOHNSON
Practice Location Address:

1320 N HAMILTON ST
HIGH POINT, NC
27262-2600

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Practice Fax:

1992119911 — FOSTER WILKINS
Practice Location Address:

1320 N HAMILTON ST , SUITE 107
HIGH POINT, NC
27262-2600

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1073958294 — SUZANNE E PORTER RN
Practice Location Address:

2600 SW THISTLE ST , CHIEF SEALTH HIGH SCHOOL
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Directions to “GENESIS FAMILY HEALTHCARE, INC ” Practice Location

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