Organization
GENESIS HEALTH SYSTEM
Active
Other names
Genesis Rural Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK G ROGERS (VICE PRESIDENT OF FINANCE)
(563) 421-6513
Entity
Organization
Contact information
Practice address
530 12TH ST, ERIE, IL 61250-9461
(309) 659-2215
(309) 659-2006
Mailing address
865 LINCOLN RD, STE L10, BETTENDORF, IA 52722-4190
(563) 355-9191
(563) 355-3419
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5727210022
DMERC
—
Enumeration date
08/22/2006
Last updated
04/16/2015
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