Genesis Medical Group Llc

LBN: Genesis Medical Group Llc
Genesis Medical Group Llc is an health care organization with primary practice located at 10802 Se Washington St , Portland OR 97216-3118. 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
10802 Se Washington St Portland OR 97216-3118
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 1013214014
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 Feb 28th, 2011
Last updated Aug 14th, 2012 - about 12 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 1013214014 NPPES
Oregon MEDICAID 500608071

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