GENOA HEALTHCARE, LLC (NPI# 1558871913) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558871913 |
| Entity Type | Organization |
| Organization Name | GENOA HEALTHCARE, LLC |
| Other Organization Name | GENOA HEALTHCARE, LLC |
| Practice Address |
1010 N Prospect St Ste 56 Bowling Green OH 43402 |
| Mailing Address |
Po Box 77030 Minneapolis MN 55480-7730 |
| Practice Telephone | 4194190104 |
| Practice Fax Number | 4199894293 |
| Mailing Telephone | 2532180830 |
| Mailing Fax Number | 2532174306 |
| Enumeration Date | 2017-10-11 |
| 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 | 333600000X | Pharmacy | Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
PMY.022873800-03 | OH | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2176536 | 01 |
| Other Name | Type Code |
|---|---|
| Genoa Healthcare, LLC | Doing Business As Name - Organization |
| 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 |
1010 N PROSPECT ST STE 56 |
| City | BOWLING GREEN |
| State | OH |
| Zip Code | 43402 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790276475 | Gregory Long | Pharmacist | 1010 N Prospect St Ste 56, Bowling Green, OH 43402-1335 | 2018-05-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316592017 | Danielle Urbaniak | Pharmacist | 722-740 South Main St, Bowling Green, OH 43402 | 2019-08-08 |
| 1013485648 | Julie Marie Knapp | Counselor | 219 South Church Street, Bowling Green, OH 43402 | 2018-11-13 |
| 1477065274 | Elizabeth Marie Leber | Social Worker | 1045 Klotz Rd., Bowling Green, OH 43402 | 2017-11-02 |
| 1093224933 | Kevin Wagner | Contractor | 19644 Hull Prairie Rd, Bowling Green, OH 43402 | 2017-09-22 |
| 1487102273 | Mary Ann Bostdorff | Registered Nurse | 1011 North Prospect St., Bowling Green, OH 43402 | 2016-09-21 |
| 1174927354 | Kristy Siegle | Counselor | 1010 North Prospect, Bowling Green, OH 43402 | 2014-10-16 |
| 1366846560 | Timothy M Burkart | Pharmacist | 1840 E. Gypsy Lane Rd, (wood County Health Department), Bowling Green, OH 43402 | 2014-10-16 |
| 1144629411 | Ledeithra Denise Mckinney | Speech-Language Pathologist | 1921 East Gypsy Lane Rd., Bowling Green, OH 43402 | 2014-08-22 |
| 1558701607 | Mark Joseph Kleeberger | Physical Therapy Assistant | 1180 N Main St, Bowling Green, OH 43402 | 2013-07-02 |
| 1417393539 | Dawn D Patridge | Massage Therapist | 536 Pearl St., Bowling Green, OH 43402 | 2013-05-15 |
| Find all providers in zip 43402 | ||||
| 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] |
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|---|---|---|---|---|
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| 1568574416 | Ely Home Infusion Inc | Pharmacy | 4863a Scottsville Rd, Bowling Green, KY 42104-7909 | 2006-08-31 |
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| 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 | ||||
| City | BOWLING GREEN |
| Zip Code | 43402 |
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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.