Provider Demographics
NPI:1679185995
Name:GENESIS MEDICAL SERVICES
Entity Type:Organization
Organization Name:GENESIS MEDICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE OFFICE
Authorized Official - Prefix:
Authorized Official - First Name:CORIE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-548-5060
Mailing Address - Street 1:1783 FOREST DR STE 106
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-4229
Mailing Address - Country:US
Mailing Address - Phone:800-548-5060
Mailing Address - Fax:301-403-1908
Practice Address - Street 1:10777 SYMPHONY PARK DR
Practice Address - Street 2:
Practice Address - City:NORTH BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20852-3485
Practice Address - Country:US
Practice Address - Phone:800-540-5060
Practice Address - Fax:301-304-1908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-18
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
No251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
No261QR0800XAmbulatory Health Care FacilitiesClinic/CenterRecovery Care
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient
No385H00000XRespite Care FacilityRespite CareGroup - Single Specialty