Organization
GENESIS ELDERCARE PHYSICIAN SERVICES I LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CATHERINE TREGOE (DIRECTOR OF BUSINESS OPERATIONS)
(410) 543-8870
Entity
Organization
Contact information
Practice address
9 HAYWOOD AVE, RUTLAND, VT 05701-4832
(410) 543-1957
Mailing address
801 N SALISBURY BLVD, SUITE 201, SALISBURY, MD 21801-3624
(410) 543-1957
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
Other
Enumeration date
12/11/2008
Last updated
12/12/2008
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