Organization
GENESIS HEALTH SYSTEM
Active
Other names
Genesis Health Group
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH MALAS (VICE PRESIDENT OF FINANCE)
(563) 421-6508
Entity
Organization
Contact information
Practice address
1351 W CENTRAL PARK AVE STE 4100, DAVENPORT, IA 52804-1847
(563) 355-9191
(563) 355-3419
Mailing address
1351 W CENTRAL PARK AVE STE 4100, DAVENPORT, IA 52804-1847
(563) 355-9191
(563) 355-3419
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
—
IA
207Q00000X
Family Medicine Physician
Primary
—
IA
207Q00000X
Family Medicine Physician
—
IL
207R00000X
Internal Medicine Physician
—
IA
207R00000X
Internal Medicine Physician
—
IL
207V00000X
Obstetrics & Gynecology Physician
—
IA
207V00000X
Obstetrics & Gynecology Physician
—
IL
208000000X
Pediatrics Physician
—
IA
208000000X
Pediatrics Physician
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0496083
—
IA
Enumeration date
09/26/2006
Last updated
03/01/2024
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