GENOA HEALTHCARE OF TENNESSEE, LLC (NPI# 1548453194) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548453194 |
| Entity Type | Organization |
| Organization Name | GENOA HEALTHCARE OF TENNESSEE, LLC |
| Practice Address |
120 Omni Dr Mc Minnville TN 37110-1331 |
| Mailing Address |
510 E Main St Auburn WA 98002-5502 |
| Practice Telephone | 9314731066 |
| Practice Fax Number | 9314731068 |
| Mailing Telephone | 2532180830 |
| Mailing Fax Number | 2532180835 |
| Enumeration Date | 2007-08-27 |
| Last Update Date | 2008-09-02 |
| Authorized Official Name | DENISE JASON (CONTRACTS ADMINISTRATOR) |
| Authorized Official Telephone | 2532180862 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | 4338 | TN | Suppliers |
| N | 333600000X | Pharmacy | 4338 | TN | Suppliers |
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
4338 | TN | Suppliers |
| Street Address |
120 OMNI DR |
| City | MC MINNVILLE |
| State | TN |
| Zip Code | 37110-1331 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235291063 | Mary Louise Ecker | Social Worker | 120 Omni Dr, Mc Minnville, TN 37110-1331 | 2006-12-15 |
| 1518049790 | Robert B Bowling | Counselor | 120 Omni Dr, Mc Minnville, TN 37110-1331 | 2006-10-19 |
| 1306928403 | Ronald Lee | Marriage & Family Therapist | 120 Omni Dr, Mc Minnville, TN 37110-1331 | 2006-10-19 |
| 1538240130 | Glenn Webb | Psychiatry & Neurology | 120 Omni Dr, Mc Minnville, TN 37110-1331 | 2006-10-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184223984 | Ramila, LLC | Pharmacy | 2652, Old Nashville Hwy, Mcminnville, TN 37110 | 2020-10-22 |
| 1598319055 | Ashley Nicole Hobbs | Registered Nurse | 1401 Sparta Street, Mcminnville, TN 37110 | 2019-08-01 |
| 1033476734 | Samantha Brooke Johnson | Occupational Therapy Assistant | 928 Old Smithville Road, Mcminnville, TENNESSEE 37110 | 2012-04-18 |
| 1245500800 | Jennifer Ann Strunk | Social Worker | 306 N. Chancery Street, Mcminnville, TN 37110 | 2012-01-12 |
| 1477858322 | Nancy M Walker | Pharmacist | 912 N Chancery Street, Mcminnville, TN 37110 | 2011-01-24 |
| 1811225568 | Mcminnville Boarding Home for The Elderly | Assisted Living Facility | 345 Garfield St., Mcminnville, TN 37110 | 2009-11-18 |
| 1750571246 | Jeremy Lee Sanders | Pharmacist | 1100 New Smithville Hwy Suite 114, Mcminnville, TN 37110 | 2007-07-31 |
| 1144383522 | Britt Allan King | Occupational Therapist | 128 Old Smithville Hwy, Mcminnville, TN 37110 | 2006-12-18 |
| 1952478992 | Jeanne Kay Ball | Physical Therapy Assistant | Nhc Mcminneville, 928 Old Smithville Rd, Mcminnville, TN 37110 | 2006-11-28 |
| 1760559702 | Amy Cheryl Fox | Occupational Therapy Assistant | Nhc Mcminnville 928 Old Smithville Rd, Mcminnville, TN 37110 | 2006-11-28 |
| Find all providers in zip 37110 | ||||
| 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 |
|---|---|---|---|---|
| 1770199432 | Boones Creek Pharmacy, Inc. | Pharmacy | 4729 N Roan St Ste 2, Johnson City, TN 37615-3886 | 2020-09-18 |
| 1164032546 | Polaris Pharmacy Services of Tennessee, LLC | Pharmacy | 7005 Wesbelt Drive, Nashville, TN 32709 | 2020-07-31 |
| 1386261030 | Jeffrey Allan Anderson | Pharmacy | 721 N Tennessee Ave, Etowah, TN 37331-1754 | 2020-06-29 |
| 1376171652 | Boatwright Drug Co., Inc | Pharmacy | 7899 Leroy Boatwright St, Millington, TN 38053-2137 | 2020-03-31 |
| 1245868850 | Seymour Pharmacy Inc. | Pharmacy | 10721 Chapman Hwy Ste 6, Seymour, TN 37865-4771 | 2020-03-30 |
| 1700423654 | Southland Ltc Pharmacy | Pharmacy | 482 Interstate Dr Ste L, Manchester, TN 37355-3485 | 2019-12-10 |
| 1104380930 | Fannon Drug Co. | Pharmacy | 606 E. Emory Rd, Powell, TN 37849 | 2019-01-25 |
| 1538663281 | Black Bear Pharmacy, Inc. | Pharmacy | 110 Keith St Sw Ste 1and2, Cleveland, TN 37311-5868 | 2018-03-19 |
| 1891231734 | Rams Pharmacy LLC | Pharmacy | 1210 Hazelwood Dr Ste D, Smyrna, TN 37167-3964 | 2017-01-17 |
| 1982056529 | Pharmblue Tennessee LLC | Pharmacy | 1113 Murfreesboro Rd Ste 319-b, Franklin, TN 37064-1306 | 2016-07-07 |
| Find all providers with the same taxonomy | ||||
| City | MC MINNVILLE |
| Zip Code | 37110 |
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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.