GENOA HEALTHCARE, LLC (NPI# 1013517390) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1013517390 |
Entity Type | Organization |
Organization Name | GENOA HEALTHCARE, LLC |
Practice Address |
1890 Waite St Ste 1 North Bend OR 97459-1229 |
Mailing Address |
Po Box 77030 Minneapolis MN 55480-7730 |
Practice Telephone | 2532180830 |
Practice Fax Number | 2532174306 |
Mailing Telephone | 2532180830 |
Mailing Fax Number | 2532174306 |
Enumeration Date | 2020-10-27 |
Last Update Date | 2020-10-27 |
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 |
Suppliers | ||
Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
Suppliers |
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 |
Street Address |
1890 WAITE ST STE 1 |
City | NORTH BEND |
State | OR |
Zip Code | 97459-1229 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1538341490 | Rhonda Knight | Registered Nurse | 1890 Waite St Ste 1, North Bend, OR 97459-1229 | 2007-12-03 |
1003445032 | Waterfall Clinic, Incorporated | Clinic/Center | 1890 Waite St Ste 1, North Bend, OR 97459-1229 | 2020-04-02 |
1437654779 | Waterfall Clinic, Incorporated | Community/Behavioral Health | 1890 Waite St Ste 1, North Bend, OR 97459-1229 | 2018-03-28 |
1720582315 | Amy Hinshaw | Nurse Practitioner | 1890 Waite St Ste 1, North Bend, OR 97459-1229 | 2018-03-20 |
1851892509 | Waterfall Clinic Incorporated | Counselor | 1890 Waite St Ste 1, North Bend, OR 97459-1229 | 2018-02-27 |
1346633476 | Waterfall Community Pharmacy | Pharmacy | 1890 Waite St Ste 1, North Bend, OR 97459-1229 | 2015-03-13 |
1255627253 | Debra Sue Guzman | Nurse Practitioner | 1890 Waite St Ste 1, North Bend, OR 97459-1229 | 2011-06-28 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1568002749 | Ya-chi Claire Chang | Nurse Practitioner | 1229 1890 Waite St #1, North Bend, OR 97459 | 2020-01-15 |
1629573977 | Heather M Coates | Counselor | 400 Virginia Ave Ste 100, North Bend, OR 97459 | 2018-03-28 |
1205257219 | Melissa Sperry | Health Educator | 510 Lockhart Street, North Bend, OR 97459 | 2013-12-17 |
1265862627 | Elizabeth Sylvester | Counselor | 1592 Monroe Street, North Bend, OR 97459 | 2013-11-22 |
1124370291 | Brian Noble Thompson | Pharmacist | 3411 Broadway St., North Bend, OR 97459 | 2012-10-12 |
1295081230 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 3411 Broadway St, North Bend, OR 97459 | 2012-07-27 |
1366728370 | Melissa Jean Kovach | Occupational Therapy Assistant | 3959 Sheridan Ave., North Bend, OR 97459 | 2011-10-24 |
1295045052 | Mary Kay Weikel | Massage Therapist | 3229 Broadway St Suite G Serenity Therapy Center, North Bend, OR 97459 | 2010-10-14 |
1902080013 | Anthony Eugene Baldacci | Registered Nurse | 1836 Meade Street, North Bend, OR 97459 | 2007-12-26 |
1952595340 | Inland Point Senior Estates Jv LLC | Clinic/Center | 2265 Inland Drive, North Bend, OR 97459 | 2007-08-29 |
Find all providers in zip 97459 |
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 |
---|---|---|---|---|
1023440864 | Olson Pharmacy Services | Pharmacy | 617 Monroe St, Oregon City, OR 97045-2336 | 2013-08-03 |
1861773798 | Grants Pass Pharmacy, Inc. | Pharmacy | 414 Sw 6th St., Grants Pass, OR 97526-2810 | 2011-09-06 |
1003051558 | Howard's Pharmacy Inc. | Pharmacy | 101 N F St, Lakeview, OR 97630-1529 | 2008-12-12 |
1558448225 | Pill Box Drugs Inc | Pharmacy | 635 N Arrowleaf Trl, Sisters, OR 97759 | 2006-11-01 |
1881776722 | Quisenberry Pharmacies Inc. | Pharmacy | 150 Liberty St Se, Salem, OR 97301-3506 | 2006-10-19 |
1093808198 | Pill Box Drugs Inc | Pharmacy | 906 Nw Kings Blvd, Corvallis, OR 97330 | 2006-10-02 |
1871690719 | Pill Box Drugs Inc | Pharmacy | 910 Nw Kings Blvd, Corvallis, OR 97330-2505 | 2006-09-20 |
1952405664 | Dept. of Human Srvcs/office of Fin. Srvcs Dba Irs/eopc/eotc/osh/osh-p | Pharmacy | 2600 Westgate, Pendleton, OR 97801-9604 | 2006-09-12 |
1780795765 | Evergreen Pharmaceutical, LLC | Pharmacy | 259 E Barnett Rd Ste L, Medford, OR 97501-7953 | 2006-08-31 |
1235240391 | Evergreen Pharmaceutical, LLC | Pharmacy | 11933 Ne Glenn Widing Dr, Portland, OR 97220-9099 | 2006-08-31 |
Find all providers with the same taxonomy |
City | NORTH BEND |
Zip Code | 97459 |
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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.