Organization
BLUE GENESIS HOLDINGS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAX WILTZ (COO)
(470) 435-9574
Entity
Organization
Contact information
Practice address
2013 WEATHERBY WAY CT, DACULA, GA 30019-7769
(470) 435-9574
Mailing address
2013 WEATHERBY WAY CT, DACULA, GA 30019-7769
(470) 435-9574
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
07/22/2019
Last updated
07/22/2019
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