Organization
GENESIS MEDICAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN R. LAYNE RPH (PRESIDENT/OWNER)
(336) 627-4600
Entity
Organization
Contact information
Practice address
113 N PIERCE STREET, EDEN, NC 27288-5018
(336) 623-5010
(336) 623-5091
Mailing address
PO BOX 747, EDEN, NC 27289-5018
(336) 623-5010
(336) 623-5091
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009134981
—
VA
01
—
0493I
BCBSNC
NC
05
—
7700081
—
NC
01
—
8209185
UNITED HEALTH CARE
GA
01
—
8209185
UNITED HEALTH CARE
TX
01
—
8209185
UNITED HEALTH CARE
UT
Enumeration date
01/04/2006
Last updated
10/15/2009
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