Provider Demographics
NPI:1306592787
Name:GENMED LLC
Entity type:Organization
Organization Name:GENMED LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:T BEYAN
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:BONAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-747-7849
Mailing Address - Street 1:PO BOX 73
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:PA
Mailing Address - Zip Code:15340-0073
Mailing Address - Country:US
Mailing Address - Phone:724-747-7849
Mailing Address - Fax:
Practice Address - Street 1:34 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:PA
Practice Address - Zip Code:15340-1100
Practice Address - Country:US
Practice Address - Phone:724-747-7849
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-24
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory