Organization
GENESIS ELDERCARE PHYSICIAN SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ERIC SHAPIRO (VP, CONTROLLER)
(410) 832-7790
Entity
Organization
Contact information
Practice address
9 HAYWOOD AVE, MOUNTAIN VIEW CENTER, RUTLAND, VT 05701
(802) 775-0007
(802) 775-6895
Mailing address
PO BOX 62946, BALTIMORE, MD 21264-2946
(410) 494-7607
(610) 925-7387
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
—
—
363LA2200X
Adult Health Nurse Practitioner
101-0025776
VT
363LG0600X
Gerontology Nurse Practitioner
101-0019819
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1104819259
—
VT
Enumeration date
07/25/2006
Last updated
08/05/2019
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us