Provider Demographics
NPI:1861750242
Name:GENESYS HEALTH ENTERPRISES, INC.
Entity type:Organization
Organization Name:GENESYS HEALTH ENTERPRISES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:G
Authorized Official - Last Name:HOLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-606-7282
Mailing Address - Street 1:1000 HEALTH PARK BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-9936
Mailing Address - Country:US
Mailing Address - Phone:810-603-8900
Mailing Address - Fax:810-606-5255
Practice Address - Street 1:1000 HEALTH PARK BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-7324
Practice Address - Country:US
Practice Address - Phone:810-606-5090
Practice Address - Fax:810-606-5522
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GENESYS HEALTH SYSTEM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-04-24
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5301005603332BX2000X, 3336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
0373650003Medicare NSC
0373650002Medicare NSC
0373650001Medicare NSC