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GENESIS ELDERCARE PHYSICIAN SERVICES, LLC - Florida Company Profile

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Company Details

Entity Name: GENESIS ELDERCARE PHYSICIAN SERVICES, LLC
Jurisdiction: FLORIDA
Filing Type: Foreign Limited Liability Co.
Status: Active
Date Filed: 22 Dec 2022 (3 years ago)
Document Number: M22000019076
FEI/EIN Number 061156428
Address: 101 E. STATE ST., KENNETT SQUARE, PA, 19348
Mail Address: 101 E. STATE ST., KENNETT SQUARE, PA, 19348
Place of Formation: PENNSYLVANIA

Key Officers & Management

Name Role Address
- Manager -
SHAINE ALEXANDER President 101 E. STATE ST., KENNETT SQUARE, PA, 19348
Bridgeford Laura Treasurer 101 E. STATE ST., KENNETT SQUARE, PA, 19348
BERG MICHAEL Secretary 101 E. STATE ST., KENNETT SQUARE, PA, 19348
SIEGEL GARY Vice President 101 E. STATE ST., KENNETT SQUARE, PA, 19348
- Agent -

National Provider Identifier

NPI Number:
1063839611

Authorized Person:

Name:
ERIC SHAPIRO
Role:
VICE PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
207RG0300X - Geriatric Medicine (Internal Medicine) Physician
Is Primary:
Yes

Contacts:

Documents

Name Date
ANNUAL REPORT 2024-04-05
ANNUAL REPORT 2023-03-22
Foreign Limited 2022-12-22

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Date of last update: 02 Aug 2025

Sources: Florida Department of State