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NPI Code Detail

MEDICARE: GENESIS HOME CARE

MEDICARE: GENESIS HOME CARE
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
1251E00000XHome Health Agency
22278H0200XHome Health Certified Respiratory Therapist
3253Z00000XIn Home Supportive Care Agency

General Provider Information

NPI Number : 1851115893
Entity Type Code : Organization
Provider Name (Legal Business Name) : GENESIS HOME CARE
Provider Business Mailing Address
First Line : 1275 STONEY FIELD PL
Second Line :
City : LAWRENCEVILLE
State : GA
Zip : 30043-3831
Country : US
Telephone Number : 404-998-9917
Fax Number :
Provider Business Practice Location Address
First Line : 2552 PITKIN AVE UNIT 152
Second Line :
City : BROOKLYN
State : NY
Zip : 11208-2498
Country : US
Telephone Number : 404-998-9917
Fax Number :
Authorized Official
Title or Position : ADMINISTRATOR
Name : LAWRENCE K BOATENG
Credential :
Telephone Number : 404-998-9917
Provider Enumeration Date : 11/14/2024
Last Update Date : 11/14/2024

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Directions to “GENESIS HOME CARE ” Practice Location

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