Provider Demographics
NPI:1881827673
Name:GENESIS HEALTH CARE
Entity Type:Organization
Organization Name:GENESIS HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REHAB MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DANA
Authorized Official - Middle Name:
Authorized Official - Last Name:BAGNATI
Authorized Official - Suffix:
Authorized Official - Credentials:OTRL
Authorized Official - Phone:856-327-2520
Mailing Address - Street 1:54 SHARP ST
Mailing Address - Street 2:
Mailing Address - City:MILLVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08332-2444
Mailing Address - Country:US
Mailing Address - Phone:856-327-2526
Mailing Address - Fax:
Practice Address - Street 1:54 SHARP ST
Practice Address - Street 2:
Practice Address - City:MILLVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08332-2444
Practice Address - Country:US
Practice Address - Phone:856-327-2700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-27
Last Update Date:2009-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00599200314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility