Organization
GENESIS ASC PARTNERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENETHA D MORAN (AUTHORIZED OFFICIAL)
(972) 763-3893
Entity
Organization
Contact information
Practice address
3400 E JOLLY RD, LANSING, MI 48910-8542
(517) 708-3200
(517) 272-1685
Mailing address
3400 E JOLLY RD, LANSING, MI 48910-8542
(517) 708-3200
(517) 272-1685
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
336817
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2261985
—
MI
01
—
40021
BLUE CARE NETWORK
MI
01
—
P00684067
RAILROAD MEDICARE
MI
Enumeration date
10/06/2006
Last updated
03/22/2018
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