Provider Demographics
NPI:1265641997
Name:GENESYS AMBULATORY HEALTH SERVICES
Entity Type:Organization
Organization Name:GENESYS AMBULATORY HEALTH SERVICES
Other - Org Name:GENESYS OCCUPATIONAL HEALTH NETWORK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:L
Authorized Official - Last Name:NAPIER
Authorized Official - Suffix:
Authorized Official - Credentials:CMA COHN
Authorized Official - Phone:810-715-4620
Mailing Address - Street 1:1460 N CENTER RD
Mailing Address - Street 2:
Mailing Address - City:BURTON
Mailing Address - State:MI
Mailing Address - Zip Code:48509-1429
Mailing Address - Country:US
Mailing Address - Phone:810-715-4620
Mailing Address - Fax:810-715-4602
Practice Address - Street 1:1460 N CENTER RD
Practice Address - Street 2:
Practice Address - City:BURTON
Practice Address - State:MI
Practice Address - Zip Code:48509-1429
Practice Address - Country:US
Practice Address - Phone:810-715-4620
Practice Address - Fax:810-715-4602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI882102OtherDOL ID #