Organization
GENESIS HEALTH SYSTEM
Active
Other names
Genesis Health Group
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK G ROGERS (VICE PRESIDENT OF FINANCE)
(563) 421-6513
Entity
Organization
Contact information
Practice address
1230 E RUSHOLME ST, DAVENPORT, IA 52803-2400
(563) 322-9150
(563) 322-9148
Mailing address
865 LINCOLN RD, SUITE L10, BETTENDORF, IA 52722-4190
(563) 441-2735
(563) 355-3419
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5727210014
DMERC
—
Enumeration date
08/21/2006
Last updated
09/28/2009
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