Provider Demographics
NPI:1437430410
Name:GENESIS HOME CARE INC
Entity Type:Organization
Organization Name:GENESIS HOME CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIE
Authorized Official - Middle Name:R
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-353-0127
Mailing Address - Street 1:609 COUNTRY CLUB DR
Mailing Address - Street 2:SUITE D
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-6208
Mailing Address - Country:US
Mailing Address - Phone:252-353-0127
Mailing Address - Fax:252-353-0137
Practice Address - Street 1:609 COUNTRY CLUB DR
Practice Address - Street 2:SUITE D
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-6208
Practice Address - Country:US
Practice Address - Phone:252-353-0127
Practice Address - Fax:252-353-0137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-02
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care