Healthsource

LBN: Rm Genesis Healthcare
Healthsource is an health care organization with primary practice located at 4518 W Market St Ste A , Greensboro NC 27407-1543. The organization recently has only one registered license in Managed Care Organizations / Health Maintenance Organization, which is considered as the primary health care specialty. Rm Genesis Healthcare can be contacted via phone (336) 235-4022, or through Smith, Roosevelt John via phone (336) 235-4022.

Contact Information

Primary practice address
4518 W Market St Ste A Greensboro NC 27407-1543
Phone: (336) 235-4022
Fax: (336) 235-4023
Website:
Map and Directions
Authorized official contact:
Name: Smith, Roosevelt John Doctor of Chiropractic (DC)
Phone: (336) 235-4022

Health care specialties

SpecialtyCodeLicense #State
Managed Care Organizations / Health Maintenance Organization 302R00000X 2930 North Carolina

Profile Details

NPI number 1861558512
LBN Legal business name Rm Genesis Healthcare
DBA Doing business as Healthsource
Authorized official Smith, Roosevelt John Doctor of Chiropractic (DC)
Entity Organization
Organization subpart 1 No
Enumeration date Dec 28th, 2006
Last updated Nov 19th, 2009 - about 16 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 1861558512 NPPES
North Carolina Other 085AM BLUE CROSS BLUE SHIELD
North Carolina Other 617755 BLUE CROSS BLUE SHIELD
North Carolina Other 264096200 BLUE CROSS BLUE SHIELD
North Carolina Other 42898 BLUE CROSS BLUE SHIELD
North Carolina Other 617755 BLUE CROSS BLUE SHIELD
North Carolina MEDICAID 89085AM BLUE CROSS BLUE SHIELD

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