Organization
GENESIS HEALTHCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY BURNIAN (DIRECTOR OF REHAB)
(304) 455-2600
Entity
Organization
Contact information
Practice address
225 RUSSELL AVE, NEW MARTINSVILLE, WV 26155-1572
(304) 455-2600
Mailing address
225 RUSSEL AVE, NEW MARTINSVILLE, WV 26155
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
PTA001388
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
22520000X
—
WV
Enumeration date
11/04/2015
Last updated
11/04/2015
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