Organization
GENESIS ELDERCARE PHYSICIAN SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC SHAPIRO (VP, CONTROLLER)
(410) 832-7790
Entity
Organization
Contact information
Practice address
415 AIRPORT RD, GRIFFIN, GA 30224-4834
(410) 543-1957
Mailing address
PO BOX 42738, TOWSON, MD 21284-2738
(410) 494-7607
(610) 925-7387
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
—
—
Other
Enumeration date
03/17/2014
Last updated
04/12/2018
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