Organization
GENESIS HEALTHCARE SYSTEM
Active
Other names
Genesis Roseville Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL NORMAN (CFO)
(740) 454-4773
Entity
Organization
Contact information
Practice address
157 S MAIN ST, ROSEVILLE, OH 43777-1238
(740) 697-0348
Mailing address
133 N MAYSVILLE AVE, ZANESVILLE, OH 43701-6112
(740) 454-5666
(740) 452-7563
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
02-707700
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0232000344
STATE LICENSE
OH
05
—
0887901
—
OH
Enumeration date
05/31/2006
Last updated
09/11/2023
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