# GENESIS5 LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** 5 star medical supply
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629437090
- **Authorized official:** ALVIN PONCE (PARTNER)
- **Authorized official phone:** (925) 324-2612

## Contact information

- **Practice address:** 7066 VILLAGE PARKWAY, DUBLIN, CA 94568
- **Practice address phone:** (925) 324-2612
- **Mailing address:** 7066 VILLAGE PKWY, DUBLIN, CA 94568-2408
- **Mailing address phone:** (925) 318-5555

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 474684618 | CA | Yes |

## Other

- **Enumeration date:** 02/15/2016
- **Last updated:** 02/15/2016