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 OF FINANCE)
(563) 421-6513
Entity
Organization
Contact information
Practice address
1520 W 53RD ST, DAVENPORT, IA 52806-2459
(563) 421-4900
(563) 421-4910
Mailing address
865 LINCOLN ROAD, STE L10, BETTENDORF, IA 52722
(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
—
5727210011
DMERC
—
Enumeration date
09/08/2006
Last updated
09/28/2009
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