Organization
GENAO'S MEDICAL SUPPLY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAYRELI GENAO DME SPECIALIST (OWNER)
(732) 324-8700
Entity
Organization
Contact information
Practice address
471 NEW BRUNSWICK AVE, PERTH AMBOY, NJ 08861-3646
(732) 324-7800
Mailing address
471 NEW BRUNSWICK AVE, PERTH AMBOY, NJ 08861-3646
(732) 324-7800
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01640863
AMERIGROUP OF NJ
NJ
01
—
60096699
HORIZON NJ HEALTH
NJ
Enumeration date
12/16/2011
Last updated
08/07/2012
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