Provider Demographics
NPI:1578577854
Name:GENESIS HEALTHCARE LLC
Entity Type:Organization
Organization Name:GENESIS HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:OBUMNEME
Authorized Official - Middle Name:K
Authorized Official - Last Name:EGWUATU
Authorized Official - Suffix:
Authorized Official - Credentials:ESQ
Authorized Official - Phone:301-943-3389
Mailing Address - Street 1:1875 I ST NW
Mailing Address - Street 2:SUITE 576
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20006-5409
Mailing Address - Country:US
Mailing Address - Phone:202-857-3281
Mailing Address - Fax:202-429-9574
Practice Address - Street 1:1875 I ST NW
Practice Address - Street 2:SUITE 576
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006-5409
Practice Address - Country:US
Practice Address - Phone:202-857-3281
Practice Address - Fax:202-429-9574
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies