GENOA HEALTHCARE, LLC (NPI# 1164035382) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164035382 |
| Entity Type | Organization |
| Organization Name | GENOA HEALTHCARE, LLC |
| Practice Address |
2100 Comer Ave Columbus GA 31904-8725 |
| 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 | 2020-08-27 |
| Last Update Date | 2020-08-27 |
| 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 |
| Vermont Business Registrations | GENOA HEALTHCARE, LLC | 18300 Cascade Avenue South, Suite 251, Tukwila, WA 98188 |
| Street Address |
2100 COMER AVE |
| City | COLUMBUS |
| State | GA |
| Zip Code | 31904-8725 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164420220 | Demetria Barnes Hendrix | Pharmacist | 2100 Comer Ave, Ambulatory Care Pharmacy, Columbus, GA 31904-8725 | 2005-07-12 |
| 1801497193 | Jacqueline Jordan | Clinic/Center | 2100 Comer Ave, Columbus, GA 31904-8725 | 2020-11-04 |
| 1033725288 | Cassandra Faye Harris | Case Management | 2100 Comer Ave, Columbus, GA 31904-8725 | 2020-09-22 |
| 1245846831 | Morgan Ashley Harris | Counselor | 2100 Comer Ave, Columbus, GA 31904-8725 | 2020-09-18 |
| 1386256097 | Diana Lynn Ezell | Counselor | 2100 Comer Ave, Columbus, GA 31904-8725 | 2020-08-24 |
| 1245840750 | Samantha Meghan Bruffy | Registered Nurse | 2100 Comer Ave, Columbus, GA 31904-8725 | 2020-08-10 |
| 1083222871 | Paulette Davis | Licensed Practical Nurse | 2100 Comer Ave, Columbus, GA 31904-8725 | 2020-07-17 |
| 1245859859 | Ryan James Aker | Case Manager/Care Coordinator | 2100 Comer Ave, Columbus, GA 31904-8725 | 2020-04-14 |
| 1477188035 | Samantha Marie Dent | Case Manager/Care Coordinator | 2100 Comer Ave, Columbus, GA 31904-8725 | 2020-03-04 |
| 1376174763 | Ebone Bunche | Licensed Practical Nurse | 2100 Comer Ave, Columbus, GA 31904-8725 | 2020-02-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821641457 | At Home Palliative Care, LLC | Nursing Care | 114 Enterprise Ct, Suite B, Columbus, GA 31904 | 2019-07-23 |
| 1285191049 | Shandra Ladell Grimes | Nurse Practitioner | 2300 Manchester Expwy St Francis Hospital, Suite C-001, Columbus, GA 31904 | 2019-02-27 |
| 1881161529 | Lesley Kathleen Simmons | Massage Therapist | 5402 15th Ave, Columbus, GA 31904 | 2018-10-31 |
| 1184190662 | Alphonsa Joseph | Nurse Practitioner | 2430 Brookstone Centre Parkway, Columbus, Georgia 31904, Columbus, GA 31904 | 2018-10-22 |
| 1568942704 | William Pearce Massey | Social Worker | 8851-1 Moore Road, Columbus, GA 31904 | 2018-08-17 |
| 1033696372 | Marlise V. Gray | Counselor | 2013 Devonshire Dr. Suite 115, Columbus, GA 31904 | 2018-07-19 |
| 1710418173 | Amanda Barnette Pruett | Behavioral Analyst | 200 Brookstone Centre Pkwy Bldg 200, Columbus, GA 31904 | 2017-03-27 |
| 1750833232 | Carrie Leigh Whitehead | Nurse Practitioner | 6228 Bradley Park Dr. Suite A, Columbus, GA 31904 | 2016-10-31 |
| 1609323369 | Shomika Lasha Battle | Registered Nurse | 2101 North Avenue, Columbus, GA 31904 | 2016-09-09 |
| 1952759219 | Peaceful River Home Care Agency | In Home Supportive Care | 738 Rudgate Road, Columbus, GA 31904 | 2016-05-27 |
| Find all providers in zip 31904 | ||||
| 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 |
|---|---|---|---|---|
| 1841680014 | Refill Rx | Pharmacy | 3433 Agler Rd., Suite 1150, Columbus, OH 48197 | 2015-01-27 |
| 1114320017 | Pharmscript of Oh LLC | Pharmacy | 1685 Westbelt Dr, Columbus, OH 43228 | 2014-10-06 |
| 1588974083 | Cdi Long Term Care LLC | Pharmacy | 11 W Duncan St., Columbus, OH 43202 | 2010-10-18 |
| 1427108356 | Doctors Park Pharmacy | Pharmacy | 2030 Doctors Park Dr, Columbus, IN 47203-2221 | 2007-01-11 |
| 1649382094 | Ncs Healthcare of Ohio, LLC | Pharmacy | 2305 Westbrooke Dr, Columbus, OH 43228-9644 | 2006-08-31 |
| 1174153977 | Tooley Drug Company | Pharmacy | 2615 13th St, Columbus, NE 68601-4915 | 2020-01-21 |
| 1083244883 | Tooley Drug Company | Pharmacy | 4306 38th St, Columbus, NE 68601-1618 | 2020-01-21 |
| 1902453228 | Trio Pharmacy | Pharmacy | 1570 Cleveland Ave, Columbus, OH 43211-2755 | 2019-08-21 |
| 1053873521 | Forward Pharmacy of Columbus, LLC | Pharmacy | 100 S Ludington St, Columbus, WI 53925-1516 | 2019-04-03 |
| 1942345574 | Pharmacy Management Group LLC | Pharmacy | 425 Main St, Columbus, MS 39701-4533 | 2007-02-21 |
| Find all providers in COLUMBUS | ||||
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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.