Organization Name: | GENESIS HEALTH SYSTEM |
NPI Number: | 1073681318 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARK KLEINSCHMIDT (CEO) |
Mailing Address: | 801 Illini Dr Silvis |
State: | IL US |
Postal Code: | 612821804 |
Phone Number: | 5634213408 |
Fax Number: | 5634213419 |
NPI Enumeration Date: | 12/04/2006 |
NPI Last Update Date: | 04/20/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR0200X |
License Number: | ========= |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Radiology |
Taxonomy Definition: |