Provider Demographics
NPI:1578755849
Name:GENESYS HEALTH ENTERPRISES INC
Entity Type:Organization
Organization Name:GENESYS HEALTH ENTERPRISES INC
Other - Org Name:GENESYS MEDICAL EQUIPMENT SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT OF COC
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:K
Authorized Official - Last Name:STEVENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-762-3662
Mailing Address - Street 1:425 N FENWAY DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:FENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48430-3810
Mailing Address - Country:US
Mailing Address - Phone:810-750-5450
Mailing Address - Fax:
Practice Address - Street 1:425 N FENWAY DR
Practice Address - Street 2:SUITE C
Practice Address - City:FENTON
Practice Address - State:MI
Practice Address - Zip Code:48430-3810
Practice Address - Country:US
Practice Address - Phone:810-750-5450
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-10
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI540B50435OtherBCBSM
MI1583785 TYPE 87Medicaid
MI0981305OtherHEALTHPLUS
MIDM250002OtherMCARE
MI1285OtherBCN
MI1583785 TYPE 87Medicaid
MI=========OtherPPOM
=========OtherVARIES COMMERCAL INS