GENOA HEALTHCARE, LLC (NPI# 1083163620) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083163620 |
| Entity Type | Organization |
| Organization Name | GENOA HEALTHCARE, LLC |
| Practice Address |
1007 N Pope St Ste P Silver City NM 88061-5161 |
| Mailing Address |
Po Box 77030 Minneapolis MN 55480-7730 |
| Practice Telephone | 5753428900 |
| Practice Fax Number | 5753884026 |
| Mailing Telephone | 2532180830 |
| Mailing Fax Number | 2532174306 |
| Enumeration Date | 2016-09-23 |
| Last Update Date | 2020-09-30 |
| Authorized Official Name | WILLIAM GUPTAIL (COO) |
| Authorized Official Telephone | 2532180830 |
| 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 |
PH00004329 | NM | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 582074 | 05 | |
| PK | 2164337 | 01 | |
| NM | 40804356 | 05 |
| 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 |
| Connecticut Business Registrations | GENOA HEALTHCARE, LLC | 18300 Cascade Avenue South, Suite 251, Tukwila, WA 98188 |
| Indiana Business Entities | GENOA HEALTHCARE, LLC | 18300 Cascade Avenue South, Suite 251, Tukwila, WA 98188 |
| Colorado Business Entities | GENOA HEALTHCARE, LLC | 18300 Cascade Ave S. Suite 251, Tukwila, WA 98188-4746 |
| Street Address |
1007 N POPE ST STE P |
| City | SILVER CITY |
| State | NM |
| Zip Code | 88061-5161 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235764127 | Tanya Jacqueline Ruiz | Case Manager/Care Coordinator | 1000 Hudson St, Silver City, NM 88061 | 2020-03-11 |
| 1326686635 | Jasmine Jaylene Abeyta | Behavior Technician | 3903 N Pinos Altos Road, Silver City, NM 88061 | 2019-12-17 |
| 1548826829 | Stephanie Trujillo | Psychologist | 2810 N. Swan St., Silver City, NM 88061 | 2019-05-13 |
| 1619453784 | Courtney Ochoa | Counselor | 3200 32nd Street Bypass, Silver City, NM 88061 | 2018-07-12 |
| 1609369206 | Tara Arias | Behavior Technician | 2875 Grand Mesa St, Silver City, NM 88061 | 2018-06-08 |
| 1205339454 | Manuel A Ortega | Counselor | 1311 N Grant St Ste A, Silver City, NM 88061 | 2018-03-14 |
| 1720587058 | Manuel A. Martinez IIi | Social Worker | 3082 32nd Street Byp, Silver City, NM 88061 | 2018-02-01 |
| 1467971986 | Hidalgo Medical Services | Clinic/Center | 3200 32nd St Bypass, Silver City, NM 88061 | 2017-09-15 |
| 1245787316 | David Thomas Rivera | Social Worker | 2039 Cottage Sand Rd., Silver City, NM 88061 | 2016-09-07 |
| 1821462540 | Anthony Alibah | Pharmacist | 100 Rosdale Road, Walgreens, Silver City, NM 88061 | 2015-11-18 |
| Find all providers in zip 88061 | ||||
| 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 |
|---|---|---|---|---|
| 1922579705 | Mesilla Valley Pharmacy & Consulting | Pharmacy | 100 Wyatt Dr Ste B, Las Cruces, NM 88005-2922 | 2018-12-05 |
| 1669954798 | Zia Pharmacy, LLC | Pharmacy | 575 S Alameda Blvd Ste 102, Las Cruces, NM 88005-2818 | 2018-09-05 |
| 1558859710 | Integral Pharmacy, LLC | Pharmacy | 109 S Second St, Gallup, NM 87301-6219 | 2018-04-24 |
| 1740659150 | State of New Mexico | Pharmacy | 41 Fort Bayard Rd, Santa Clara, NM 88026 | 2015-09-16 |
| 1730585142 | Zia Pharmacy, LLC | Pharmacy | 2820 Broadbent Pkwy Ne Ste C, Albuquerque, NM 87107-1621 | 2014-11-12 |
| 1902169816 | Badger Health Corp | Pharmacy | 1275 S 2nd St Ste A, Raton, NM 87740-2209 | 2012-06-18 |
| 1356364343 | May Pharmacy Cedar Crest Inc | Pharmacy | 12129 Hwy 14 N, Cedar Crest, NM 87008-9492 | 2006-07-25 |
| 1386679710 | Ncs Healthcare of New Mexico, LLC | Pharmacy | 9019 Washington St Ne, Suite B1, Albuquerque, NM 87113-2435 | 2006-07-12 |
| 1245239185 | Mjrx II LLC | Pharmacy | 1445 Wyoming Blvd Ne, Albuquerque, NM 87112-3849 | 2005-07-20 |
| 1760018212 | Pharmex Inc | Pharmacy | 2300 E 30th St Ste B-101, Farmington, NM 87401-8991 | 2020-03-17 |
| Find all providers with the same taxonomy | ||||
| City | SILVER CITY |
| Zip Code | 88061 |
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.