Provider Demographics
NPI:1093750184
Name:GENESIS ELDERCARE NATIONAL CENTERS, INC.
Entity Type:Organization
Organization Name:GENESIS ELDERCARE NATIONAL CENTERS, INC.
Other - Org Name:WOODMONT CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CORPORATE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:DROPESKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-925-4045
Mailing Address - Street 1:101 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:KENNETT SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19348-3109
Mailing Address - Country:US
Mailing Address - Phone:610-925-4436
Mailing Address - Fax:610-925-4351
Practice Address - Street 1:11 DAIRY LN
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22405-2663
Practice Address - Country:US
Practice Address - Phone:540-371-9414
Practice Address - Fax:540-371-4501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-20
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VANH2735314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
02LPOtherCAREFIRST - PROV/INQ#
227680OtherUNITED - MAMSI
HI7OtherCAREFIRST - IND/PPO
VA004952464Medicaid
47596OtherAMERIGROUP
HI7OtherCAREFIRST BLUECHOICE
1039169OtherAETNA-HMO
184539OtherSOUTHERN HEALTH
184539OtherSOUTHERN HEALTH
227680OtherUNITED - MAMSI
=========OtherCIGNA - MID-ATLANTIC
=========OtherHNFS-TRICARE
=========OtherNATIONAL CAPITAL PPO
02LPOtherCAREFIRST - PROV/INQ#
=========OtherUNITED - FIDELITY