Organization
GENESIS VASCULAR OF POOLER, LLC
Active
Parent organization
GENESIS GLOBAL HEALTHCARE
Other names
GV of Pooler
Organization subpart
Yes
Provider details
NPI number
Legal business name
GENESIS GLOBAL HEALTHCARE
Authorized official
JAMES THOMAS O'DARE III (PRINCIPAL)
(856) 335-5025
Entity
Organization
Contact information
Practice address
1000 TOWNE CENTER BLVD, BUILDING 400, POOLER, GA 31322-4052
(912) 662-0223
(912) 662-0224
Mailing address
575 N ROUTE 73, STE A6, WEST BERLIN, NJ 08091-9289
(856) 335-5025
(856) 213-9269
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
—
—
207RI0011X
Interventional Cardiology Physician
Primary
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
2086S0129X
Vascular Surgery Physician
—
—
Other
Enumeration date
04/16/2015
Last updated
11/13/2015
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