Organization
GENESIS HEALTH SYSTEM
Active
Other names
Genesis Health Group
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK G ROGERS (VICE PRESIDENT)
(563) 421-6513
Entity
Organization
Contact information
Practice address
532 N CODY RD, LECLAIRE, IA 52753-9645
(563) 289-3008
(563) 289-3024
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
—
5727210016
DMERC
—
Enumeration date
08/21/2006
Last updated
09/28/2009
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