Provider Demographics
NPI:1275968844
Name:GENVENTURES, INC.
Entity Type:Organization
Organization Name:GENVENTURES, INC.
Other - Org Name:GENESIS FIRSTMED PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:G
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:563-421-6513
Mailing Address - Street 1:3900 28TH AVENUE DRIVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:MOLINE
Mailing Address - State:IL
Mailing Address - Zip Code:61265-5016
Mailing Address - Country:US
Mailing Address - Phone:309-281-2590
Mailing Address - Fax:309-281-2599
Practice Address - Street 1:3900 28TH AVENUE DRIVE
Practice Address - Street 2:SUITE 110
Practice Address - City:MOLINE
Practice Address - State:IL
Practice Address - Zip Code:61265-5016
Practice Address - Country:US
Practice Address - Phone:309-281-2590
Practice Address - Fax:309-281-2599
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GENVENTURES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-09-13
Last Update Date:2013-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies