| Genesis Primecare | |
|
2131 S Mobberly Ave Longview TX 75602-3563 | |
| (903) 758-3551 | |
| Not Available |
| Full Name | Genesis Primecare |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 2131 S Mobberly Ave, Longview, Texas |
| Authorized Official Name and Position | Carla Roadcap (CEO) |
| Authorized Official Contact | 9039273782 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Genesis Primecare Po Box 1326 Marshall TX 75671-1326 Ph: (903) 927-3782 | Genesis Primecare 2131 S Mobberly Ave Longview TX 75602-3563 Ph: (903) 758-3551 |
| NPI Number | 1669872560 |
|---|---|
| Provider Enumeration Date | 08/27/2014 |
| Last Update Date | 08/28/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669872560 | NPI | - | NPPES |
| 340584701 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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