Provider Demographics
NPI:1851497788
Name:GENESIS HOMECARE
Entity Type:Organization
Organization Name:GENESIS HOMECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:HOGREFE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-428-4440
Mailing Address - Street 1:417 E 4TH ST
Mailing Address - Street 2:
Mailing Address - City:DELL RAPIDS
Mailing Address - State:SD
Mailing Address - Zip Code:57022-1927
Mailing Address - Country:US
Mailing Address - Phone:605-428-4440
Mailing Address - Fax:605-428-4484
Practice Address - Street 1:417 E 4TH ST
Practice Address - Street 2:
Practice Address - City:DELL RAPIDS
Practice Address - State:SD
Practice Address - Zip Code:57022-1927
Practice Address - Country:US
Practice Address - Phone:605-428-4440
Practice Address - Fax:605-428-4484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD41001000156994T5T001332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies