GENOA HEALTHCARE, LLC (NPI# 1386024560) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386024560 |
| Entity Type | Organization |
| Organization Name | GENOA HEALTHCARE, LLC |
| Practice Address |
134 Prevatt Rd Dothan AL 36301-5427 |
| Mailing Address |
Po Box 77030 Minneapolis MN 55480-7730 |
| Practice Telephone | 3346993858 |
| Practice Fax Number | 3346993868 |
| Mailing Telephone | 2532180830 |
| Mailing Fax Number | 2532174306 |
| Enumeration Date | 2015-06-03 |
| Last Update Date | 2020-03-13 |
| Authorized Official Name | WILLIAM GUPTAIL (COO) |
| Authorized Official Telephone | 2532180830 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
113591 | AL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2154636 | 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 |
| Vermont Business Registrations | GENOA HEALTHCARE, LLC | 18300 Cascade Avenue South, Suite 251, Tukwila, WA 98188 |
| Street Address |
134 PREVATT RD |
| City | DOTHAN |
| State | AL |
| Zip Code | 36301-5427 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215990734 | Spectracare Health Systems, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 134 Prevatt Rd, Dothan, AL 36301-5427 | 2006-04-07 |
| 1720477623 | Kelli Vickers | Counselor | 134 Prevatt Rd, Dothan, AL 36301-5427 | 2015-01-15 |
| 1992115133 | Christina Hussey | Social Worker | 134 Prevatt Rd, Dothan, AL 36301-5427 | 2014-04-28 |
| 1760808042 | Tarama Lashay Fleming | Counselor | 134 Prevatt Rd, Dothan, AL 36301-5427 | 2014-03-11 |
| 1790083400 | Northeast Pharmaceuticals Inc | Pharmacy | 134 Prevatt Rd, Dothan, AL 36301-5427 | 2011-03-03 |
| 1184956872 | Richard Reginald Brookins | Counselor | 134 Prevatt Rd, Ste. 1, Dothan, AL 36301-5427 | 2010-02-04 |
| 1568638534 | Wiregrass Mental Health Board Inc | Clinic/Center | 134 Prevatt Rd, Dothan, AL 36301-5427 | 2008-04-30 |
| 1679753636 | Tammy Alecia Mccarter | Counselor | 134 Prevatt Rd, Dothan, AL 36301-5427 | 2007-11-07 |
| 1144429325 | Robin Gay Quire | Registered Nurse | 134 Prevatt Rd, Dothan, AL 36301-5427 | 2007-07-17 |
| 1134328156 | Diana Phelps Golson | Registered Nurse | 134 Prevatt Rd, Dothan, AL 36301-5427 | 2007-07-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043862931 | Pharmacy Center South LLC | Pharmacy | 2826 Ross Clark Circle, Suite 103, Dothan, AL 36301 | 2019-07-11 |
| 1851879167 | Attallah Cotton | Social Worker | 101 Eastridge Dr, Dothan, AL 36301 | 2018-07-31 |
| 1225522709 | Nichole Johnson Prestwood | Nurse Practitioner | 2431 W Main St Ste 501, Dothan, AL 36301 | 2018-06-19 |
| 1750805818 | Kimberly Danielle Austin | Speech-Language Pathologist | 404 Darlington Cir, Dothan, AL 36301 | 2017-07-31 |
| 1952794885 | Lori P. Granberry | Pharmacist | 2131 Ross Clark Circle, Dothan, AL 36301 | 2015-03-17 |
| 1801286059 | Robert Cody Russell | Nurse Practitioner | 1118 Ross Clark Circle, Suite 100, Dothan, AL 36301 | 2015-01-27 |
| 1720407646 | Michael Kreger | Anesthesiology | 1118 Ross Clark Cir Ste 700, Dothan, AL 36301 | 2014-04-08 |
| 1063851277 | Carlos Stanford Clark II | Family Medicine | 201 Doctors Drive, Dothan, AL 36301 | 2013-06-20 |
| 1639489313 | Robert Fort Hambaugh Jr. | Specialist | 712 Woodland Drive, Dothan, AL 36301 | 2010-10-15 |
| 1588894976 | Atwill Lamar Miller Jr. | Urology | 1908 Fairview Avenue, Dothan, AL 36301 | 2009-07-20 |
| Find all providers in zip 36301 | ||||
| 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 |
|---|---|---|---|---|
| 1609867167 | J L Scott Inc | Pharmacy | 2021 Alexander Dr Ste B, Dothan, AL 36301-3003 | 2005-11-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760024947 | Remedi Seniorcare of Alabama, LLC | Pharmacy | 4908 Moores Mill Rd Unit A, Huntsville, AL 35811-1512 | 2019-10-09 |
| 1821646894 | Senior Care Pharmacy Inc | Pharmacy | 101b Villa Dr Ste B-260, Daphne, AL 36526-4653 | 2019-09-03 |
| 1477027720 | Oms Pharmacy, Inc. | Pharmacy | 1800 Mcfarland Blvd E Ste 334, Tuscaloosa, AL 35404-5882 | 2019-01-18 |
| 1225418403 | Genoa Healthcare, LLC | Pharmacy | 425 5th Ave Nw Rm 92, Attalla, AL 35954-2214 | 2015-06-03 |
| 1235519414 | Genoa Healthcare, LLC | Pharmacy | 2201 Arlington Ave Ste B, Bessemer, AL 35020-4221 | 2015-06-03 |
| 1003296286 | Genoa Healthcare, LLC | Pharmacy | 2520 Fairlane Dr Ste 300, Montgomery, AL 36116-1653 | 2015-06-03 |
| 1902220932 | Medchoice Pharmacy Services, LLC | Pharmacy | 1 Southern Way, Mobile, AL 36619-1210 | 2014-02-11 |
| 1063846673 | Pharmacy Services of Mobile LLC | Pharmacy | 747 Lakeside Dr, Mobile, AL 36693-5113 | 2013-08-30 |
| 1114359817 | Integracare Pharmacy Inc. | Pharmacy | 199 Corporate Woods Dr, Alabaster, AL 35007-4844 | 2013-08-05 |
| 1649619222 | Caredirect Rx of Jackson, LLC | Pharmacy | 112 Celtic Dr Ste 200a, Madison, AL 35758-1800 | 2013-06-18 |
| 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.