| Genesis Health Group, Dewitt | |
|
1008 11th St De Witt IA 52742-1210 | |
| (563) 659-9137 | |
| (563) 659-4438 |
| Full Name | Genesis Health Group, Dewitt |
|---|---|
| Speciality | Clinic/Center |
| Location | 1008 11th St, De Witt, Iowa |
| Authorized Official Name and Position | Joseph D Malas (CFO) |
| Authorized Official Contact | 5634216508 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Genesis Health Group, Dewitt Po Box 4028 Rock Island IL 61204-4028 Ph: () - | Genesis Health Group, Dewitt 1008 11th St De Witt IA 52742-1210 Ph: (563) 659-9137 |
| NPI Number | 1205533056 |
|---|---|
| Provider Enumeration Date | 02/13/2023 |
| Last Update Date | 12/15/2023 |
| Medicare PECOS PAC ID | 7214841436 |
|---|---|
| Medicare Enrollment ID | O20230511002539 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205533056 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| Provider Name | Heather J Ohnemus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851673933 PECOS PAC ID: 9830350164 Enrollment ID: I20170317001664 |
| Provider Name | Allison Edmunds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518647932 PECOS PAC ID: 4284080664 Enrollment ID: I20231020001112 |
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