GENOA HEALTHCARE, LLC (NPI# 1013286160) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013286160 |
| Entity Type | Organization |
| Organization Name | GENOA HEALTHCARE, LLC |
| Practice Address |
9890 Clayton Rd Ste 125 Saint Louis MO 63124-1644 |
| Mailing Address |
Po Box 77030 Minneapolis MN 55480-7730 |
| Practice Telephone | 3142270995 |
| Practice Fax Number | 3145699479 |
| Mailing Telephone | 2532180830 |
| Mailing Fax Number | 2532174306 |
| Enumeration Date | 2011-12-19 |
| Last Update Date | 2020-03-20 |
| Authorized Official Name | WILLIAM ROBERT GUPTAIL (COO) |
| Authorized Official Telephone | 6516890258 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
2015006805 | MO | Suppliers |
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
PHY.006880-NR | LA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2133149 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972103257 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 555 Towner St Ste 1120d, Ypsilanti, MI 48198-5723 | 2020-10-27 |
| 1477153757 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 299 W Railroad Ave Ste P, Crestview, FL 32536-4053 | 2020-10-27 |
| 1033719323 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 7001 Blue Ridge Blvd Ste P, Raytown, MO 64133-5629 | 2020-10-27 |
| 1326648601 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 225 Carlton Davidson Ln Rm 1, Coal Grove, OH 45638-2924 | 2020-10-27 |
| 1912507211 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 5690 Santa Teresita Drive, Suite A2, Room P1, Santa Teresa, NM 88008 | 2020-10-27 |
| 1760080238 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 3807 N 7th St Ste P, Phoenix, AZ 85014-5005 | 2020-10-15 |
| 1174121982 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 807 Lawn Ave Ste 104, Sellersville, PA 18960-1549 | 2020-10-14 |
| 1457959272 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 281 Laclair St Rm 135, Coos Bay, OR 97420-2988 | 2020-10-14 |
| 1811595622 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 2500 W Washington Ave Ste 103, Las Vegas, NV 89106-3731 | 2020-10-14 |
| 1245844000 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 1441 E 84th Pl Rm 120, Merrillville, IN 46410-6578 | 2020-08-31 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | GENOA HEALTHCARE, LLC | 18300 Cascade Avenue South, Suite 251, Tukwila, WA 98188 |
| Washington State Corporations | GENOA HEALTHCARE, LLC | 18300 Cascade Ave S # 251, Tukwila, WA 98188 |
| Massachusetts Corporations | GENOA HEALTHCARE, LLC | 18300 Cascade Avenue South, Suite 251, Tukwila, WA 98188 |
| Ohio Business Entities | GENOA HEALTHCARE, LLC | 510 East Main Street, Auburn, WA 98002 |
| Vermont Business Registrations | GENOA HEALTHCARE, LLC | 18300 Cascade Avenue South, Suite 251, Tukwila, WA 98188 |
| Street Address |
9890 CLAYTON RD STE 125 |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63124-1644 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366726945 | Jean R Tenholder | Pharmacist | 9890 Clayton Rd Ste 125, Saint Louis, MO 63124-1644 | 2011-09-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174174775 | Nicholas Simpson | Nurse Practitioner | 8857 Ladue Road, St. Louis, MO 63124 | 2019-09-25 |
| 1144774647 | Carolyn Ashley Myles Versical | Psychologist | 26 Godwin Ln, Saint Louis, MO 63124 | 2016-08-12 |
| 1740669373 | Victor's Home Care Cds, LLC | Hospice Care, Community Based | 8420 Delmar Blvd, Ste 507, St. Louis, MO 63124 | 2015-05-28 |
| 1851784490 | Bryan Watanabe Dds Ladue Dental Group, PC | Dentist | 8859 Ladue Road, Ladue, MO 63124 | 2015-03-06 |
| 1689072324 | Ladue Internal Medicine, LLC | Internal Medicine | 8857 A Ladue Rd., Ladue, MO 63124 | 2014-12-11 |
| 1043557150 | Ronald Nathan Riner | Internal Medicine | 9847 Waterbury Drive, St. Louis, MO 63124 | 2013-01-09 |
| 1295099638 | David Stuart Sonderman | Pediatrics | 8888 Ladue Road, Ste 100, Saint Louis, MO 63124 | 2012-06-29 |
| 1255637799 | Kyu S Her | Pediatrics | 624 Haverford Road, St. Louis, MO 63124 | 2011-02-01 |
| 1194983833 | Roberte Kuhlman | Orthopaedic Surgery | 12 Upper Barnes, St Louis, MO 63124 | 2008-05-29 |
| 1467507673 | Mark William Aylward | Dentist | 9216 Clayton Road, Suite 118, St Louis, MO 63124 | 2007-01-25 |
| Find all providers in zip 63124 | ||||
| Taxonomy Code | 3336L0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Long Term Care Pharmacy |
| A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780229690 | Dalpoas Group Inc | Pharmacy | 4245 Forest Park Ave Ste B, Saint Louis, MO 63108-2810 | 2019-11-14 |
| 1326316969 | Gateway Apothecary | Pharmacy | 4473 Forest Park Ave, Saint Louis, MO 63108-2211 | 2011-12-11 |
| 1982901419 | Pharmacy Corporation of America | Pharmacy | 105 Arc Dr, Saint Louis, MO 63146-3502 | 2011-02-18 |
| 1518139534 | Everspring LLC | Pharmacy | 1884 Lackland Hill Pkwy Ste 6, Saint Louis, MO 63146-3569 | 2008-03-31 |
| 1578658571 | N-f Pharmacy, Inc | Pharmacy | 8 Crestwood Executive Ctr, Saint Louis, MO 63126-1904 | 2006-10-04 |
| 1780615393 | Gateway Rx LLC | Pharmacy | 2000 Westport Center Dr, Saint Louis, MO 63146-3564 | 2006-07-05 |
| 1801341292 | Car Pharmacy LLC | Pharmacy | 5378 Southwest Ave, Saint Louis, MO 63139-1446 | 2016-08-16 |
| 1619016862 | State of Missouri | Pharmacy | 5351 Delmar Blvd, Saint Louis, MO 63112-3146 | 2007-02-05 |
| 1376682708 | State of Missouri | Pharmacy | 5300 Arsenal St, Saint Louis, MO 63139-1463 | 2007-02-05 |
| 1730244161 | Imran Pharmacy | Pharmacy | 3737 N Kingshighway Blvd, Ste 100, Saint Louis, MO 63115-1736 | 2006-12-26 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63124 |
Please comment or provide details below to improve the information on GENOA HEALTHCARE, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.