Organization
GENESIS DME, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONNIE L STREAT (CEO)
(912) 285-5200
Entity
Organization
Contact information
Practice address
2501 PLANT AVE, WAYCROSS, GA 31501-6046
(912) 285-5200
(912) 285-9378
Mailing address
2501 PLANT AVE, WAYCROSS, GA 31501-6046
(912) 285-5200
(912) 285-9378
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BC3200X
Customized Equipment (DME)
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
335E00000X
Prosthetic/Orthotic Supplier
AT000581
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000891096A
—
GA
05
—
000891096B
—
GA
Enumeration date
12/04/2006
Last updated
11/14/2016
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