Genesis Medical Group, Llc.

LBN: Genesis Medical Group, Llc.
Genesis Medical Group, Llc. is an health care organization with primary practice located at 1338 Commerce Ave Ste D , Longview WA 98632-3743. The organization recently has only one registered license in Suppliers / Prosthetic/Orthotic Supplier, which is considered as the primary health care specialty. Genesis Medical Group, Llc. can be contacted via phone (503) 699-1911, or through Brown, Wyatt James via phone (503) 699-1911.

Contact Information

Primary practice address
1338 Commerce Ave Ste D Longview WA 98632-3743
Phone: (503) 699-1911
Fax: (503) 699-1912
Website:
Map and Directions
Authorized official contact:
Name: Brown, Wyatt James CPED
Phone: (503) 699-1911

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Prosthetic/Orthotic Supplier 335E00000X

Profile Details

NPI number 1326290248
LBN Legal business name Genesis Medical Group, Llc.
DBA Doing business as
Authorized official Brown, Wyatt James CPED
Entity Organization
Organization subpart 1 Yes
Enumeration date Oct 22nd, 2008
Last updated Apr 3rd, 2012 - about 14 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1326290248 NPPES
Washington MEDICAID 2005775

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