GENOA HEALTHCARE, LLC (NPI# 1356797690) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356797690 |
| Entity Type | Organization |
| Organization Name | GENOA HEALTHCARE, LLC |
| Practice Address |
1430 Wilkins Cir Ste 154 Casper WY 82601-1336 |
| Mailing Address |
Po Box 77030 Minneapolis MN 55480-7730 |
| Practice Telephone | 3074395199 |
| Practice Fax Number | 3072654675 |
| Mailing Telephone | 2532180830 |
| Mailing Fax Number | 2532174306 |
| Enumeration Date | 2016-05-05 |
| Last Update Date | 2020-03-05 |
| 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 | 333600000X | Pharmacy | Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
RI0160 | WY | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2160410 | 01 |
| 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 |
1430 WILKINS CIR STE 154 |
| City | CASPER |
| State | WY |
| Zip Code | 82601-1336 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407472715 | Kira Christine Schaab | Student in an Organized Health Care Education/Training Program | University of Wyoming Fmrp - Casper 1522 East A Street, Casper, WY 82601 | 2020-06-23 |
| 1386111300 | Kyle David Gordon | Pharmacist | 2625 E. 2nd St., Pharmacy, Casper, WY 82601 | 2018-10-29 |
| 1225534050 | Stephanie Wendling | Social Worker | 143 S Summit St., Casper, WY 82601 | 2018-04-02 |
| 1457877987 | Deer Creek Dentistry, PC | Dentist | 514 South Durbin Street, Casper, WY 82601 | 2017-08-16 |
| 1679096382 | Rachael Kristin Clark | Case Management | 2317 Absaroka Trail, Bar Nunn, WY 82601 | 2017-07-25 |
| 1366998692 | Trenton Vonburg | Occupational Therapy Assistant | 2744 Fairdale Ave, Casper, WY 82601 | 2016-08-28 |
| 1619326618 | Traci L Aguilar | Massage Therapist | 221 S. Walcott, Casper, WY 82601 | 2016-06-09 |
| 1801256656 | Anita Walker | Speech-Language Pathologist | 851 Werner Ct., Ste. 100, Sensational Kids, Casper, WY 82601 | 2016-03-07 |
| 1528444304 | Jack Miller | Pharmacist | 1262 S. Conwell Stc, Casper, WY 82601 | 2015-08-04 |
| 1437556453 | Kelly Jo Plessman | Nurse Practitioner | 2521 East 15th Street, Casper, WY 82601 | 2014-11-20 |
| Find all providers in zip 82601 | ||||
| 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 |
|---|---|---|---|---|
| 1346233186 | Geneva Woods Pharmacy Wyoming, LLC | Pharmacy | 2546 E 2nd St Bldg 100, Building 100, Casper, WY 82609-2062 | 2005-08-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730291659 | Ricker Drug Inc | Pharmacy | 1801 Big Horn Ave, Worland, WY 82401-2912 | 2006-08-31 |
| 1881160190 | Cde LLC | Pharmacy | 131 10th St, Evanston, WY 82930-3421 | 2018-10-15 |
| 1629476270 | Vilas Pharmacy | Pharmacy | 224 E Main Street, Sundance, WY 82729 | 2014-12-15 |
| 1700910411 | South Lincoln Hospital District | Pharmacy | 711 Onyx St, Kemmerer, WY 83101-3214 | 2007-03-15 |
| 1104965003 | Powell Valley Health Care, Inc. | Pharmacy | 777 Avenue H, Powell, WY 82435-2260 | 2007-02-06 |
| 1972657179 | Teton County Hospital District | Pharmacy | 625 E Broadway Ave, Jackson, WY 83001-8642 | 2007-01-23 |
| 1992874218 | Campbell County Memorial Hospital | Pharmacy | 501 S Burma Ave, Gillette, WY 82716-3426 | 2006-11-08 |
| 1942290549 | West Park Hospital District | Pharmacy | 707 Sheridan Ave, Cody, WY 82414-3409 | 2005-10-25 |
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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.