GENOA HEALTHCARE, LLC (NPI# 1104335207) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104335207 |
| Entity Type | Organization |
| Organization Name | GENOA HEALTHCARE, LLC |
| Practice Address |
6401 E Washington St Indianapolis IN 46219-6614 |
| Mailing Address |
Po Box 77030 Minneapolis MN 55480-7730 |
| Practice Telephone | 3176623755 |
| Practice Fax Number | 3176082255 |
| Mailing Telephone | 2532180830 |
| Enumeration Date | 2017-09-21 |
| Last Update Date | 2020-03-26 |
| 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 |
| 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 |
| Street Address |
6401 E WASHINGTON ST |
| City | INDIANAPOLIS |
| State | IN |
| Zip Code | 46219-6614 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871568402 | Mark A Bustamante | Internal Medicine | 6401 E Washington St, Indianapolis, IN 46219-6614 | 2006-02-17 |
| 1639721525 | Amy Elizabeth Lewis | Nurse Practitioner | 6401 E Washington St, Indianapolis, IN 46219-6614 | 2019-07-11 |
| 1851895387 | Jessica Birge | Nurse Practitioner | 6401 E Washington St, Indianapolis, IN 46219 | 2018-03-20 |
| 1407302078 | Heather Marie Dumond | Pharmacist | 6401 E Washington St, Indianapolis, IN 46219 | 2016-09-01 |
| 1215383021 | Practice Services of Indiana PC | Family Medicine | 6401 E Washington St, Indianapolis, IN 46219-6614 | 2016-05-11 |
| 1588038475 | Kelly Sue Davis | Nurse Practitioner | 6401 E Washington St, Indianapolis, IN 46219-6614 | 2015-11-16 |
| 1073995338 | Osh-in Physicians Group, PC | Family Medicine | 6401 E Washington St, Indianapolis, IN 46219-6614 | 2015-06-23 |
| 1245612944 | Bernadette Ashley | Nurse Practitioner | 6401 E Washington St, Indianapolis, IN 46219-6614 | 2015-06-18 |
| 1790197283 | Vivian Gaines-thompson | Nurse Practitioner | 6401 E Washington St, Indianapolis, IN 46219-6614 | 2014-06-02 |
| 1881861714 | Jerry J Fry II | Social Worker | 6401 E Washington St, Indianapolis, IN 46219-6614 | 2008-05-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518571157 | Kara Kathryn Berning | Dietitian, Registered | 2040 N. Shadeland Ave, Suite 130, Indianapolis, IN 46219 | 2020-09-01 |
| 1780223750 | Erin Cannon | Specialist | 1543 N Post Rd, Indianapolis, IN 46219 | 2019-12-23 |
| 1073151239 | Tanicka Elizabeth Word | Behavior Technician | 6635 E 21st Street, West Building, Indianapolis, IN 46219 | 2019-12-18 |
| 1790322527 | Arlington Westend Dental LLC | Dentist | 5900 E 10th St, Indianapolis, IN 46219 | 2019-11-27 |
| 1336645985 | Lynell Westbrook Gates | Counselor | 1311 N Arlington Ave Ste 102, Indianapolis, IN 46219 | 2018-04-03 |
| 1861991689 | Comfort Dental LLC | Clinic/Center | 8151 E 21st St., Indianapolis, Indianapolis, IN 46219 | 2018-02-07 |
| 1467811570 | Fresenius Medical Care Indiana, LLC | Clinic/Center | 6701 E 21st St, Indianapolis, IN 46219 | 2016-02-17 |
| 1992197289 | Casey Baker | Physician Assistant | 1500 N Ritter Ave (medical Associates, LLP), Indianapolis, IN 46219 | 2015-02-24 |
| 1811398407 | Adam Romesser | Pharmacist | 8907 E. 10th St., Indianapolis, IN 46219 | 2014-09-15 |
| 1225448673 | Justin Stauffer | Pharmacist | 5903 E Pleasant Run Parkway North Dr, Indianapolis, IN 46219 | 2014-05-06 |
| Find all providers in zip 46219 | ||||
| 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 |
|---|---|---|---|---|
| 1669030102 | Meds To You LLC | Pharmacy | 8250 Bash St Ste A3, Indianapolis, IN 46250-1938 | 2019-05-30 |
| 1174091557 | Rubicon Dtp, LLC | Pharmacy | 5751 W 73rd St # A, Indianapolis, IN 46278-1741 | 2018-11-05 |
| 1235388356 | Prairestone Pharmacy LLC | Pharmacy | 9320 Priority Way West Dr, Indianapolis, IN 46240-1468 | 2008-09-12 |
| 1760048755 | Rubicon Dtp, LLC | Pharmacy | 5751 W 73rd St # A, Indianapolis, IN 46278-1741 | 2019-05-15 |
| 1780151191 | Extended Pharmacy 2 LLC | Pharmacy | 9240 N Meridian St, Indianapolis, IN 46260-1880 | 2018-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003437609 | Damasius Inc | Pharmacy | 6949 Kennedy Ave Ste C, Hammond, IN 46323-2245 | 2020-05-05 |
| 1568099703 | In Touch of Indy, LLC | Pharmacy | 851 Columbia Rd Ste 190, Plainfield, IN 46168-7587 | 2020-03-26 |
| 1083188973 | Circle City Pharmacy, LLC | Pharmacy | 65 E Garner Rd Ste 200, Brownsburg, IN 46112-7867 | 2019-01-14 |
| 1962870295 | Pca Corrections LLC | Pharmacy | 1740 Williamsburg Dr Ste A, Jeffersonville, IN 47130-8066 | 2015-09-03 |
| 1407235013 | Cppltc LLC | Pharmacy | 482 W Navajo St Ste B, West Lafayette, IN 47906-1940 | 2015-05-28 |
| 1871986596 | N&m Investments | Pharmacy | 30 S Water St Ste B, Franklin, IN 46131-2316 | 2015-03-05 |
| 1588911895 | United Rx, LLC | Pharmacy | 2325 Pointe Pkwy, Carmel, IN 46032-3294 | 2012-08-07 |
| 1265674097 | Pauls Pharmacy Inc | Pharmacy | 4111 N Saint Joseph Ave, Evansville, IN 47720-1206 | 2009-03-25 |
| 1952577173 | Grandview Healthcare, L.L.C. | Pharmacy | 3402 Congressional Pkwy Ste A, Fort Wayne, IN 46808-4440 | 2008-05-07 |
| 1427108356 | Doctors Park Pharmacy | Pharmacy | 2030 Doctors Park Dr, Columbus, IN 47203-2221 | 2007-01-11 |
| Find all providers with the same taxonomy | ||||
| City | INDIANAPOLIS |
| Zip Code | 46219 |
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.