Provider Demographics
| NPI: | 1316187214 |
|---|---|
| Name: | GENESIS HEALTH SERVICES, INC. |
| Entity Type: | Organization |
| Organization Name: | GENESIS HEALTH SERVICES, INC. |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | PRESIDENT/CEO |
| Authorized Official - Prefix: | MR |
| Authorized Official - First Name: | JAMES |
| Authorized Official - Middle Name: | E |
| Authorized Official - Last Name: | MCCLOUD |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 941-321-3081 |
| Mailing Address - Street 1: | 3333 N WASHINGTON BLVD |
| Mailing Address - Street 2: | SUTE 3 |
| Mailing Address - City: | SARASOTA |
| Mailing Address - State: | FL |
| Mailing Address - Zip Code: | 34234-6221 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 941-321-3081 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 3333 N WASHINGTON BLVD |
| Practice Address - Street 2: | SUTE 3 |
| Practice Address - City: | SARASOTA |
| Practice Address - State: | FL |
| Practice Address - Zip Code: | 34234-6221 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 941-321-3081 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2009-03-05 |
| Last Update Date: | 2009-09-15 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 261Q00000X | Ambulatory Health Care Facilities | Clinic/Center | |
| No | 261QA0005X | Ambulatory Health Care Facilities | Clinic/Center | Ambulatory Family Planning Facility |
| No | 261QC1500X | Ambulatory Health Care Facilities | Clinic/Center | Community Health |
| No | 261QD0000X | Ambulatory Health Care Facilities | Clinic/Center | Dental |
| No | 261QF0050X | Ambulatory Health Care Facilities | Clinic/Center | Family Planning, Non-Surgical |
| No | 261QH0100X | Ambulatory Health Care Facilities | Clinic/Center | Health Service |
| No | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) |
| No | 261QM0850X | Ambulatory Health Care Facilities | Clinic/Center | Adult Mental Health |
| No | 261QM0855X | Ambulatory Health Care Facilities | Clinic/Center | Adolescent and Children Mental Health |
| No | 261QM1300X | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty |
| No | 261QP2000X | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy |
| No | 261QP2300X | Ambulatory Health Care Facilities | Clinic/Center | Primary Care |
| No | 261QR0200X | Ambulatory Health Care Facilities | Clinic/Center | Radiology |
| No | 261QR0206X | Ambulatory Health Care Facilities | Clinic/Center | Radiology, Mammography |
| No | 261QU0200X | Ambulatory Health Care Facilities | Clinic/Center | Urgent Care |
