Provider Demographics
NPI:1538838636
Name:GENESIS HEALTHCARE PRODUCTS OF LOS ANGELES COUNTY INC.
Entity type:Organization
Organization Name:GENESIS HEALTHCARE PRODUCTS OF LOS ANGELES COUNTY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARILOU
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-432-6500
Mailing Address - Street 1:212 S ATLANTIC BLVD STE 202
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90022-1783
Mailing Address - Country:US
Mailing Address - Phone:323-432-6500
Mailing Address - Fax:
Practice Address - Street 1:212 S ATLANTIC BLVD STE 202
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90022-1783
Practice Address - Country:US
Practice Address - Phone:323-432-6500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-10
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies