GENOA HEALTHCARE, LLC (NPI# 1194370213) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194370213 |
| Entity Type | Organization |
| Organization Name | GENOA HEALTHCARE, LLC |
| Practice Address |
3229 Broadway Ste 107 Gary IN 46409-1041 |
| Mailing Address |
Po Box 77030 Minneapolis MN 55480-7730 |
| Practice Telephone | 2198818796 |
| Practice Fax Number | 2198845082 |
| Mailing Telephone | 2532180830 |
| Mailing Fax Number | 2532174306 |
| Enumeration Date | 2019-08-06 |
| 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 |
| Street Address |
3229 BROADWAY STE 107 |
| City | GARY |
| State | IN |
| Zip Code | 46409-1041 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316027998 | Nhi Home Base Service Corp. | Clinic/Center | 4795 Broadway, Gary, IN 46409 | 2006-10-17 |
| 1164891404 | Megan Burgess | Counselor | 4795 Broadway, Gary, IN 46409 | 2015-09-16 |
| 1366677213 | Merideth Krashonda Owens | Counselor | 4795 Broadway, Gary, IN 46409 | 2009-05-21 |
| 1548530439 | Sibis Counseling Center LLC | Counselor | 3195 Broadway Lowr Level, Gary, IN 46409-1006 | 2012-01-09 |
| 1750303343 | Adolphus A Anekwe | Specialist | 3195 Broadway, Gary, IN 46409-1006 | 2006-07-24 |
| 1215219084 | Broadway Dental Services | Dentist | 3195 Broadway, Gary, IN 46409-1006 | 2011-09-16 |
| 1528392156 | Tonya A. Harvey | Nurse Practitioner | 3195 Broadway, Gary, IN 46409-1006 | 2009-09-29 |
| 1629196761 | Broadway Medical Corporation, PC | Specialist | 3195 Broadway, Gary, IN 46409-1006 | 2007-03-27 |
| 1023166758 | Frank Edward Pate | Dentist | 3195 Broadway, Gary, IN 46409-1006 | 2007-01-08 |
| 1528173853 | Edwin Kenneth Mcdonald IIi | Dentist | 3195 Broadway, Gary, IN 46409-1006 | 2006-08-19 |
| Find all providers in zip 46409 | ||||
| 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 |
|---|---|---|---|---|
| 1255611216 | Genoa Healthcare, LLC | Pharmacy | 1100 W 6th Ave, Gary, IN 46402-1711 | 2011-08-23 |
| 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 |
| 1669030102 | Meds To You LLC | Pharmacy | 8250 Bash St Ste A3, Indianapolis, IN 46250-1938 | 2019-05-30 |
| 1083188973 | Circle City Pharmacy, LLC | Pharmacy | 65 E Garner Rd Ste 200, Brownsburg, IN 46112-7867 | 2019-01-14 |
| 1174091557 | Rubicon Dtp, LLC | Pharmacy | 5751 W 73rd St # A, Indianapolis, IN 46278-1741 | 2018-11-05 |
| 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 |
| Find all providers with the same taxonomy | ||||
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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.