GENOA HEALTHCARE, LLC (NPI# 1487093043) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487093043 |
| Entity Type | Organization |
| Organization Name | GENOA HEALTHCARE, LLC |
| Practice Address |
230 Main Street Ext Ste A Middletown CT 06457-4470 |
| Mailing Address |
Po Box 77030 Minneapolis MN 55480-7730 |
| Practice Telephone | 8603164405 |
| Practice Fax Number | 8603441704 |
| Mailing Telephone | 2532180830 |
| Mailing Fax Number | 2532174306 |
| Enumeration Date | 2013-06-17 |
| Last Update Date | 2020-03-11 |
| 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 | 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 |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | BOP | PCY.0002267 | 01 |
| NCPDP | 0723191 | 01 | |
| DEA | FG4073576 | 01 | |
| NPI | 1487093043 | 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 |
230 MAIN STREET EXT STE A |
| City | MIDDLETOWN |
| State | CT |
| Zip Code | 06457-4470 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699391961 | Meghan Harrington | Behavior Technician | 101 Centerpoint Drive #243, Middletown, CT 06457 | 2020-06-22 |
| 1427619626 | Collaborative Aba Services, LLC | Behavioral Analyst | 515 Centerpoint Drive, Suite 205, Middletown, CT 06457 | 2019-06-27 |
| 1376100339 | Kimberly Tynik | Pharmacist | 451 Fowler Ave, Middletown, CT 06457 | 2019-05-24 |
| 1184101263 | Tabrez Adil | Dentist | 675 Main St., Middletown, CT 06457 | 2018-07-23 |
| 1326535337 | Rehan Khan | Non-emergency Medical Transport (VAN) | 765 Country Club Rd, Middletown, CT 06457 | 2018-04-16 |
| 1366950206 | State of Connecticut | Psychiatric Hospital | 70 O'brien Drive, Middletown, CT 06457 | 2018-01-12 |
| 1902324536 | Cynthia Tine | Physical Therapy Assistant | 628 Congdon Street, Middletown, CT 06457 | 2017-09-04 |
| 1619494390 | Nathan Douglas Roy | Specialist/Technologist | 431 Briarwood Lane, Middletown, CT 06457 | 2017-08-24 |
| 1598286502 | Rachel Hoffman Whelen | Registered Nurse | 420 Saybrook Road, Suite A, Middletown, CT 06457 | 2017-06-29 |
| 1003358326 | Rebecca Rotondo | Social Worker | 230 Main Street Extension, Act Team, Gilead Community Services, Middletown, CT 06457 | 2016-11-17 |
| Find all providers in zip 06457 | ||||
| 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 |
|---|---|---|---|---|
| 1740658889 | Evine LLC | Pharmacy | 54 Tuttle Pl, Middletown, CT 06457-1863 | 2015-09-07 |
| 1356979439 | Kratzer Pharmacy Inc | Pharmacy | 711 S Breiel Blvd, Middletown, OH 45044-6201 | 2020-04-01 |
| 1063869238 | Middletown Ltc Pharmacy LLC | Pharmacy | 280 Route 211 E, Suite 112, Middletown, NY 10940-3109 | 2016-05-18 |
| 1366770729 | Genoa Healthcare, LLC | Pharmacy | 1036 S Verity Pkwy, Middletown, OH 45044-5513 | 2009-11-24 |
| 1114095874 | Continuumcare Pharmacy LLC | Pharmacy | 1100 Central Ave, 1st Flr, Middletown, OH 45044-4011 | 2006-12-01 |
| 1083638415 | Shore Pharmaceutical Providers | Pharmacy | 73 County Highway 108, Middletown, NY 10940-6948 | 2006-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447898523 | Beacon Pharmacy LLC | Pharmacy | 42 Windsor Ave, Vernon, CT 06066-2438 | 2019-12-19 |
| 1992189146 | Wassef LLC | Pharmacy | 535 Boston Post Rd, Old Saybrook, CT 06475-1506 | 2015-07-17 |
| 1558704072 | Care 4 U Pharmacy, Inc. | Pharmacy | 216 Christian Ln, Suite B, Berlin, CT 06037-1450 | 2013-04-15 |
| 1609095868 | Danielson Pharmacy Inc | Pharmacy | 77 A Westcott Rd, Danielson, CT 06239 | 2007-04-25 |
| 1881791093 | Value Healthcare Services LLC | Pharmacy | 525 Knotter Dr, Cheshire Industrial Park, Cheshire, CT 06410-1100 | 2006-09-20 |
| 1851401814 | James L. Trifiro | Pharmacy | 1300 Hopmeadow St, Simsbury, CT 06070-1411 | 2006-08-30 |
| 1336170349 | Partners of Connecticut, LLC | Pharmacy | 6 Thompson Rd, East Windsor, CT 06088-9626 | 2006-07-06 |
| 1629077912 | Arrow Prescription Center 14 Inc | Pharmacy | 100 Woodland St, Hartford, CT 06105-1223 | 2005-07-19 |
| 1780689836 | Masonic Healthcare Center | Pharmacy | 22 Masonic Ave, Wallingford, CT 06492-3048 | 2005-06-16 |
| 1124636469 | Nutmeg Pharmacy Moodus LLC | Pharmacy | 38 William F Palmer Rd, Moodus, CT 06469-1131 | 2020-07-22 |
| Find all providers with the same taxonomy | ||||
| City | MIDDLETOWN |
| Zip Code | 06457 |
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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.