Provider Demographics
NPI:1629715602
Name:GENUINE CARE HEALTHCARE SYSTEMS LLC
Entity Type:Organization
Organization Name:GENUINE CARE HEALTHCARE SYSTEMS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FNP/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:FNPC
Authorized Official - Phone:307-214-4537
Mailing Address - Street 1:1202 CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001-6700
Mailing Address - Country:US
Mailing Address - Phone:307-426-4916
Mailing Address - Fax:877-585-7008
Practice Address - Street 1:1202 CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-6700
Practice Address - Country:US
Practice Address - Phone:307-426-4916
Practice Address - Fax:877-585-7008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-19
Last Update Date:2022-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty