GENOA HEALTHCARE, LLC (NPI# 1578050712) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578050712 |
| Entity Type | Organization |
| Organization Name | GENOA HEALTHCARE, LLC |
| Other Organization Name | GENOA HEALTHCARE, LLC |
| Practice Address |
19750 Burt Rd Ste P Detroit MI 48219-2078 |
| Mailing Address |
Po Box 77030 Minneapolis MN 55480-7730 |
| Practice Telephone | 3132215494 |
| Practice Fax Number | 3135333420 |
| Mailing Telephone | 2532180830 |
| Mailing Fax Number | 2532174306 |
| Enumeration Date | 2018-04-13 |
| 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 | 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 |
|---|---|---|---|
| PK | 2177238 | 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 |
| Street Address |
19750 BURT RD STE P |
| City | DETROIT |
| State | MI |
| Zip Code | 48219-2078 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891396008 | Betty Jean Fairchild-el | Home Health Aide | 20018 Norhtrop, Detroit, MI 48219 | 2020-11-04 |
| 1134787633 | Behavioral Health Professionals, Inc | Family Medicine | 19750 Burt Road, Detroit, MI 48219 | 2019-05-31 |
| 1255997755 | Shvaughn Laniece Nunley | Social Worker | 18422 W Mcnichols Rd, Detroit, MI 48219 | 2019-05-10 |
| 1770081168 | D & D Enterprise Group LLC | Durable Medical Equipment & Medical Supplies | 17405 Lahser, 202, Detroit, MI 48219 | 2018-01-31 |
| 1972011369 | Fibers of The Family LLC | Home Health | 16800 Edinborough Rd, Detroit, MI 48219 | 2018-01-19 |
| 1871049684 | Monique Jackson | Occupational Therapist | 21630 Jessel Ave, Detroit, MI 48219 | 2016-08-31 |
| 1114379773 | Audrey Hopkins | Licensed Practical Nurse | 20277 Redfren, Detroit, MI 48219 | 2016-07-07 |
| 1649628785 | Erin Bianco | Social Worker | 17321 Telegraph Rd., Detroit, MI 48219 | 2016-05-31 |
| 1144674664 | Lucinda Galmon-wallace | Technician, Other | 24424 Telegraph Road, Detroit, MI 48219 | 2016-04-21 |
| 1598120925 | Faith's Place LLC | Psychiatric Residential Treatment Facility | 16725 Blackstone Street, Detroit, MI 48219 | 2015-12-30 |
| Find all providers in zip 48219 | ||||
| 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 |
|---|---|---|---|---|
| 1699711101 | Henry Ford Health System | Pharmacy | 7800 W Outer Dr Ste 240, Detroit, MI 48235-3458 | 2006-06-22 |
| 1326525965 | 20201 West Seven Mile Drugs Inc | Pharmacy | 20201 W 7 Mile Rd, Detroit, MI 48219 | 2018-07-26 |
| 1811273626 | Genoa Healthcare, LLC | Pharmacy | 1700 Waterman St, Detroit, MI 48209-2022 | 2011-10-25 |
| 1760765614 | Genoa Healthcare, LLC | Pharmacy | 5716 Michigan Ave, Detroit, MI 48210-3039 | 2011-09-27 |
| 1306151295 | Seven Mile Pharmacy LLC | Pharmacy | 14400 Gratiot Ave, Detroit, MI 48205-2307 | 2010-08-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437772159 | Krx Medication Consultants | Pharmacy | 8266 Fernwood St, Augusta, MI 49012 | 2020-05-28 |
| 1235751306 | Ypsilanti Family Pharmacy, Inc. | Pharmacy | 2287 Ellsworth Rd Ste A, Ypsilanti, MI 48197-4805 | 2020-05-12 |
| 1366082935 | Home Town Pharmacy Inc | Pharmacy | 1114 W South Airport Rd, Traverse City, MI 49686-4739 | 2020-01-13 |
| 1619510328 | Great Lakes Pharmacies I Inc | Pharmacy | 6213 Chicago Rd Ste 200, Warren, MI 48092-1697 | 2019-10-25 |
| 1710520143 | H & L Drugs Inc | Pharmacy | 1455 S Lapeer Rd Ste 101, Lake Orion, MI 48360-1468 | 2019-10-17 |
| 1225688229 | Guardian Pharmacy of Grand Rapids, LLC | Pharmacy | 2930 29th St Se, Grand Rapids, MI 49512-1723 | 2019-09-12 |
| 1457905259 | Senior Care Rx LLC | Pharmacy | 24293 Telegraph Rd Ste 130, Southfield, MI 48033-7924 | 2019-07-30 |
| 1063071637 | Smart Rx LLC | Pharmacy | 25464 Van Born Rd, Dearborn Heights, MI 48125 | 2019-06-07 |
| 1457812117 | Pharmtek LLC | Pharmacy | 3307 Orchard Lake Rd, Keego Harbor, MI 48320-1308 | 2019-03-26 |
| 1801350772 | Prestige Specialty Pharmacy 2 | Pharmacy | 31700 Van Dyke Ave Ste B, Warren, MI 48093-7949 | 2019-01-24 |
| 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.