GENOA HEALTHCARE LLC (NPI# 1215445085) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215445085 |
| Entity Type | Organization |
| Organization Name | GENOA HEALTHCARE LLC |
| Practice Address |
8441 Wayzata Blvd, Suite 340 Golden Valley MN 55426-1372 |
| Mailing Address |
Po Box 77030 Minneapolis MN 55480-7730 |
| Practice Telephone | 9527468185 |
| Practice Fax Number | 9527468187 |
| Mailing Telephone | 2532180830 |
| Mailing Fax Number | 2532174306 |
| Enumeration Date | 2018-01-16 |
| Last Update Date | 2020-09-21 |
| Authorized Official Name | WILLIAM ROBERT GUPTAIL (COO) |
| Authorized Official Telephone | 2532180830 |
| Is Organization Subpart | Y |
| Parent Organization Name | GENOA HEALTHCARE LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
Suppliers | ||
| Y | 3336M0003X |
Pharmacy Specialization: Managed Care Organization Pharmacy |
Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659313435 | Genoa Healthcare LLC | Durable Medical Equipment & Medical Supplies | 500 Hancock St, Ste 100, Saginaw, MI 48602-4224 | 2006-06-13 |
| 1447744255 | Genoa Healthcare LLC | Durable Medical Equipment & Medical Supplies | 3046 West 127th Street, Blue Island, IL 60406-1827 | 2018-06-15 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Genoa Healthcare LLC | 707 South Grady Way, Suite 700, Renton, WA 98057 |
| Iowa Business Entities | GENOA HEALTHCARE LLC | 707 South Grady Way, Suite 700, Renton, WA 98057 |
| Oregon Corporations, Companies and Business Names | GENOA HEALTHCARE LLC | 707 South Grady Way, Suite 700, Renton, WA 98057 |
| North Carolina Corporations | Genoa Healthcare LLC | 160 Mine Lake Ct Ste 200, Raleigh, NC 27615 |
| Connecticut Business Registrations | GENOA HEALTHCARE LLC | 707 S. Grady Way, Renton, WA 98057 |
| Virginia Business Entities | Genoa Healthcare LLC | 707 S. Grady Way, Suite 700, Renton, Washington 98057 |
| Street Address |
8441 WAYZATA BLVD, SUITE 340 |
| City | GOLDEN VALLEY |
| State | MN |
| Zip Code | 55426-1372 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821657545 | Big Brain Concussion Recovery & Chiropractic Pa | Chiropractor | 3313 Republic Ave., St. Louis Park, MN 55426 | 2019-06-06 |
| 1912485095 | Daniel Raies | Optometrist | 8900 Minnesota 7, St Louis Park, MN 55426 | 2018-08-01 |
| 1649756040 | Wayside House, Inc. | Clinic/Center | 1349 Jersey Ave S, St. Louis Park, MN 55426 | 2018-07-18 |
| 1104302884 | Superior Caregivers, LLC | In Home Supportive Care | 1319 Lancaster Ave., St. Louis Park, MN 55426 | 2018-07-16 |
| 1396234266 | Caitlin Kwiatkowski | Behavior Technician | 7010 Mn-7, St.louis Park, MN 55426 | 2018-05-07 |
| 1497244313 | Kelly Ann Clancey | Behavior Technician | 7010 Highway 2, Saint Louis Park, MN 55426 | 2018-05-07 |
| 1770072696 | Ashleigh Hakala | Behavior Technician | 7010 Highway 7 St. Louis Park Mn 55426, St. Louis Park, MN 55426 | 2018-05-07 |
| 1689181521 | Glenda Miles | Registered Nurse | 7316 Cedar Lake Road, Apt 8, St Louis Park, MN 55426 | 2017-12-31 |
| 1174041875 | Kristen Webb | Physician Assistant | 3931 Louisiana Ave S, Suite E-500, St. Louis Park, MN 55426 | 2017-09-01 |
| 1447775549 | Belinda Sue Bliss | Marriage & Family Therapist | 3301 Decatur Lane, Saint Louis Park, MN 55426 | 2017-08-09 |
| Find all providers in zip 55426 | ||||
| Taxonomy Code | 3336M0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Managed Care Organization Pharmacy |
| A pharmacy owned by a managed care organization (MCO) used by pharmacists for the compounding and dispensing of medicinal preparations to that MCO’s covered members only. |
| 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] |
| City | GOLDEN VALLEY |
| Zip Code | 55426 |
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.