Organization
GENESIS HEALTH SYSTEM
Active
Other names
Genesis Medical Center Davenport
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK ROGERS (INTERIM CFO)
(563) 421-6513
Entity
Organization
Contact information
Practice address
1227 E RUSHOLME ST, DAVENPORT, IA 52803-2459
(563) 421-3402
(563) 421-3419
Mailing address
1227 E RUSHOLME ST, DAVENPORT, IA 52803-2459
(563) 421-3402
(563) 421-3419
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
62303
BLUE CROSS DIALYSIS
IA
Enumeration date
06/08/2006
Last updated
07/21/2022
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