GENOA HEALTHCARE, LLC (NPI# 1548747629) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548747629 |
| Entity Type | Organization |
| Organization Name | GENOA HEALTHCARE, LLC |
| Practice Address |
140 North Frontage Road, Room 171 Mansfield Center CT 06250 |
| Mailing Address |
Po Box 77030 Minneapolis MN 55480-7730 |
| Practice Telephone | 8604554245 |
| Practice Fax Number | 8607575885 |
| Mailing Telephone | 2532180830 |
| Mailing Fax Number | 2532174306 |
| Enumeration Date | 2018-07-23 |
| 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 | 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 |
| 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 |
140 NORTH FRONTAGE ROAD, ROOM 171 |
| City | MANSFIELD CENTER |
| State | CT |
| Zip Code | 06250 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922610765 | Rebecca Hinckley | Physical Therapist | 175 Stafford Road, Mansfield Center, CT 06250 | 2020-08-22 |
| 1649801184 | Kristine Leslie Dimartino | Marriage & Family Therapist | Natchaug Hospital Sachem House, 151 Storrs Road, Mansfield Center, CT 06250 | 2020-02-03 |
| 1942845508 | Philip Fank De Ricco | Massage Therapist | 590 Ash St, Mansfield, CT 06250 | 2019-11-07 |
| 1134772858 | Lauren Curtis | Counselor | 140 North Frontage Road, Mansfield Ctr, CT 06250 | 2019-07-22 |
| 1366958480 | Mansfield Mental Health & Addiction Medicine | Psychiatry & Neurology | 18-e Ledgebrook Drive, 18-e, Mansfield Ctr, CT 06250 | 2017-12-27 |
| 1124499629 | Laura Jean Lassow | Social Worker | 70 Jacobs Hill Rd, Mansfield Center, CT 06250 | 2015-10-12 |
| 1508105891 | Raymond Karl Bopp | Surgery | 533 Wormwood Hill Road, Mansfield Center, CT 06250 | 2013-02-06 |
| 1992026900 | Carole Laurie Olderman | Social Worker | 189 Storrs Road, 06250, Natchaug Hospital, Mansfield, CT 06250 | 2010-06-14 |
| 1427384775 | Maurice Samuel Lapointe | Marriage & Family Therapist | 365 Storrs Road, Mansfield, CT 06250 | 2009-10-21 |
| 1134360480 | Pasquale Joseph Perfetto | Counselor | 155 Storrs Road, Suite A, Mansfield, CT 06250 | 2009-03-17 |
| Find all providers in zip 06250 | ||||
| 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 |
|---|---|---|---|---|
| 1447898523 | Beacon Pharmacy LLC | Pharmacy | 42 Windsor Ave, Vernon, CT 06066-2438 | 2019-12-19 |
| 1740658889 | Evine LLC | Pharmacy | 54 Tuttle Pl, Middletown, CT 06457-1863 | 2015-09-07 |
| 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 |
| Find all providers with the same taxonomy | ||||
| City | MANSFIELD CENTER |
| Zip Code | 06250 |
Please comment or provide details below to improve the information on GENOA HEALTHCARE, LLC.
| 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.