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Organization

GENESIS DME, INC.

Active
Parent organization
GENESIS DME, INC.
Organization subpart
Yes

Provider details

NPI number
Legal business name
GENESIS DME, INC.
Authorized official
MR. DONNIE L STREAT SR. (CEO)
(912) 285-5200
Entity
Organization

Contact information

Practice address
201 WESTSIDE DR, DOUGLAS, GA 31533-3529
(912) 393-1250
(912) 393-1248
Mailing address
2501 PLANT AVE, WAYCROSS, GA 31501-6046
(912) 285-5200
(912) 285-9378

Taxonomy

Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
335E00000X
Prosthetic/Orthotic Supplier

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003150824A
GA
Enumeration date
05/27/2010
Last updated
09/28/2016
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