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
239 PLEASANT ST, PLEASANT VIEW NURSING CENTER, CONCORD, NH 03301
(603) 224-6561
(603) 224-8530
Mailing address
PO BOX 62946, BALTIMORE, MD 21264-2946
(410) 494-7607
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
—
—
363LG0600X
Gerontology Nurse Practitioner
045267-23-03
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30212261
—
NH
Enumeration date
07/25/2006
Last updated
08/05/2019
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