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Contact Information

GENESIS HEALTH AND WELLNESS LLC
8211 W STATE ROUTE 66
NEWBURGH, IN47630-2534
 Phone: 812-858-1005
 Fax: 812-858-1001
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Customized Equipment

332BC3200X 87 All Other Suppliers
 

General Practice

208D00000X 99 Physician/Undefined Physician type[6]
 

Nutrition, Education

133NN1002X
Indicates primary specialty

NPI Profile & details for GENESIS HEALTH AND WELLNESS LLC

NPI Number 1336470616
LBN Legal business name GENESIS HEALTH AND WELLNESS LLC
Authorized official SHAUN TYMCHAK - (DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 01/26/2010
Last updated 08/30/2012 - About 14 years ago
Identifiers
IN License # 08002011A
IN Medicaid 201085220A
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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