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Organization

GENESIS DME, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RYAN HODGE (MEMBER)
(316) 269-1414
Entity
Organization

Contact information

Practice address
121 MAIN ST W, OAK HILL, WV 25901-2943
(866) 211-4817
Mailing address
135 N MAIN ST, WICHITA, KS 67202-1400
(316) 269-1414
(316) 263-6019

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
335E00000X
Prosthetic/Orthotic Supplier

Other

Enumeration date
08/05/2009
Last updated
08/05/2009
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