Organization
GENESIS HEALTH SYSTEM
Active
Other names
GENESIS CONVENIENT CARE DAVENPORT
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK G ROGERS (VP OF FINANCE)
(563) 421-6513
Entity
Organization
Contact information
Practice address
1520 W 53RD ST, DAVENPORT, IA 52806-2459
(563) 421-3800
(563) 421-3810
Mailing address
PO BOX 765, EAST MOLINE, IL 61244-0765
(563) 355-9200
(563) 355-3415
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0243972
—
IA
01
—
08691
BLUE CROSS/BLUE SHIELD IA
IA
01
—
387175
HEALTHLINK
—
01
—
66023
HEALTH ALLIANCE
—
01
—
903630
HARVARD PILGRIM
—
01
—
IA0106
JDHC
—
Enumeration date
07/11/2006
Last updated
07/21/2022
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