GENOA HEALTHCARE, LLC (NPI# 1467906206) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467906206 |
| Entity Type | Organization |
| Organization Name | GENOA HEALTHCARE, LLC |
| Practice Address |
741 Scholl Rd Ste P1 Mansfield OH 44907-1571 |
| Mailing Address |
Po Box 77030 Minneapolis MN 55480-7730 |
| Practice Telephone | 5673074600 |
| Practice Fax Number | 4195250007 |
| Mailing Telephone | 2532180830 |
| Mailing Fax Number | 2532174306 |
| Enumeration Date | 2016-08-10 |
| Last Update Date | 2020-03-24 |
| 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 |
PMY.022643800-03 | OH | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2162563 | 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 |
741 SCHOLL RD STE P1 |
| City | MANSFIELD |
| State | OH |
| Zip Code | 44907-1571 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922660224 | Nicole Pawuk | Pharmacist | 741 Scholl Rd Ste P1, Mansfield, OH 44907-1571 | 2019-07-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053932434 | Kerri Nichole Tolliver | Licensed Practical Nurse | Mansfield Comprehensive Treatment Center, 475 Lexington Ave, Mansfield, OH 44907 | 2020-04-27 |
| 1790325371 | Gabrielle Smith | Licensed Practical Nurse | 707 Scholl Rd, Mansfield, OH 44907 | 2020-01-10 |
| 1912544982 | Heidi L Mathews | Behavior Technician | 270 Sterkel Blvd., Mansfield, OH 44907 | 2019-12-09 |
| 1851942254 | Misty J Kline | Licensed Practical Nurse | 707 Scholl Rd., Mansfield, OH 44907 | 2019-09-26 |
| 1528533320 | Ohio Treatment Center, LLC | Clinic/Center | 475 Lexington Ave., Mansfield, OH 44907 | 2018-10-08 |
| 1750898722 | Hannah Rose Hardin | Behavior Technician | 1033 Larchwood R, Mansfield, OH 44907 | 2017-12-29 |
| 1932548856 | Jessica Alexis Taylor | Counselor | 641 Scholl Rd., Mansfield, OH 44907 | 2013-06-25 |
| 1336495258 | Sonal Sinha | Psychiatry & Neurology | 341 Cline Ave Ste 1, Mansfield, OH 44907 | 2012-07-29 |
| 1427321579 | Tara Kightlinger | Community Health Worker | 442 Brenda Dr, Mansfield, OH 44907 | 2012-02-21 |
| 1649557620 | William Scott Olar | Chiropractor | 1179 Lexington Ave, Mansfield, OH 44907 | 2011-11-04 |
| Find all providers in zip 44907 | ||||
| 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 |
|---|---|---|---|---|
| 1306268297 | Valentine Long Term Care LLC | Pharmacy | 407 Polk St, Mansfield, LA 71052-2405 | 2014-01-10 |
| 1215034053 | Mansfield Drug Inc | Pharmacy | 132 Jefferson St, Mansfield, LA 71052-2602 | 2006-09-20 |
| 1578677555 | Valentine Pharmacy Inc | Pharmacy | 116 Jefferson St, Mansfield, LA 71052-2602 | 2006-08-18 |
| 1164997169 | Derhann Co. LLC | Pharmacy | 1001 Matlock Rd Ste 105, Mansfield, TX 76063-3443 | 2018-10-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194323162 | East Ohio Regional Hospital | Pharmacy | 90 N 4th Street, Martins Ferry, OH 43935 | 2020-10-13 |
| 1083228852 | Harvest Grove Ltc LLC | Pharmacy | 10335 S Medallion Dr, Cincinnati, OH 45241-4825 | 2020-08-31 |
| 1801416789 | Pill Box Inc | Pharmacy | 1400 Sr 125, Amelia, OH 45102-2650 | 2020-04-21 |
| 1386271591 | Easterday Pharmacy LLC | Pharmacy | 1696 S. Arch Ave, Alliance, OH 44601 | 2020-03-26 |
| 1659911105 | Pillbox Pharmacy, LLC | Pharmacy | 324 Main St Ste B, Toledo, OH 43605-2038 | 2020-01-13 |
| 1053967364 | Ksar LLC | Pharmacy | 2245 W Dublin Granville Rd Ste 103, Worthington, OH 43085-3336 | 2019-08-13 |
| 1629639281 | Hhc Enterprises Inc | Pharmacy | 1451 Yauger Rd Ste 1h, Mount Vernon, OH 43050-7902 | 2019-06-25 |
| 1639730369 | Pharm Investco LLC | Pharmacy | 434 Alexandersville Rd, Miamisburg, OH 45342-3658 | 2019-06-24 |
| 1710542220 | Kratzer Pharmacy Inc. | Pharmacy | 187 W Locust St, Wilmington, OH 45177 | 2019-05-09 |
| 1760963326 | Fitzgerald Seaman Pharmacy | Pharmacy | 17860 St Rt 247, Seaman, OH 45679 | 2018-08-22 |
| 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.