Provider Demographics
NPI:1720049257
Name:GENESYS ORTHOTICS AND PROSTHETICS, LLC
Entity Type:Organization
Organization Name:GENESYS ORTHOTICS AND PROSTHETICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP PROFESSIONAL & SUPPORT SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:JOY
Authorized Official - Middle Name:M
Authorized Official - Last Name:FINKENBINER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-606-6565
Mailing Address - Street 1:2598 GENESYS PKWY
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-8069
Mailing Address - Country:US
Mailing Address - Phone:810-606-6570
Mailing Address - Fax:810-606-6571
Practice Address - Street 1:2598 GENESYS PKWY
Practice Address - Street 2:
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-8069
Practice Address - Country:US
Practice Address - Phone:810-606-6570
Practice Address - Fax:810-606-6571
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-01
Last Update Date:2016-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3389268 TYPE 85Medicaid
510B504710OtherBCBSM
MI58004OtherNPN
MI0990317OtherHEALTHPLUS OF MICHIGAN
MI1467OtherBCN
MI3389268 TYPE 85Medicaid
MI58004OtherNPN