Organization · NPI-2
Genesis Health System
Family Medicine · Durant, IA
NPI number1295841047
StatusActive
Last updated in NPPESSep 28, 2009
Details
- NPI
- 1295841047
- Entity type
- Organization (NPI-2)
- Legal business name
- Genesis Health System
- Organization subpart
- No
- Enumeration date
- Aug 22, 2006
- Last updated
- Sep 28, 2009
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
Other names
- Genesis Health Group (Doing Business As)
Practice location
619 5th StreetDurant, IA 52747
Phone 563-785-4487 · Fax 563-785-6681
Mailing address
865 Lincoln RdSte L10
Bettendorf, IA 52722-4190
Phone 563-355-9191 · Fax 563-355-3419
Authorized official
Mark G Rogers
Vice President
5634216513
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