GENOA HEALTHCARE, LLC (NPI# 1578741872) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578741872 |
| Entity Type | Organization |
| Organization Name | GENOA HEALTHCARE, LLC |
| Practice Address |
200 12th Street Ext Princeton WV 24740-2329 |
| Mailing Address |
Po Box 77030 Minneapolis MN 55480-7730 |
| Practice Telephone | 3044876337 |
| Practice Fax Number | 3044872022 |
| Mailing Telephone | 2532180830 |
| Mailing Fax Number | 2532174306 |
| Enumeration Date | 2008-02-08 |
| Last Update Date | 2020-03-25 |
| 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 |
|---|---|---|---|---|---|
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
SP0552369 | WV | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2111657 | 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 |
| Vermont Business Registrations | GENOA HEALTHCARE, LLC | 18300 Cascade Avenue South, Suite 251, Tukwila, WA 98188 |
| Connecticut Business Registrations | GENOA HEALTHCARE, LLC | 18300 Cascade Avenue South, Suite 251, Tukwila, WA 98188 |
| Street Address |
200 12TH STREET EXT |
| City | PRINCETON |
| State | WV |
| Zip Code | 24740-2329 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134160641 | Olga M. Hurt | Counselor | 200 12th Street Ext, Princeton, WV 24740-2329 | 2006-06-08 |
| 1043810336 | Jessica Nichols | Case Manager/Care Coordinator | 200 12th Street Ext, Princeton, WV 24740-2329 | 2020-10-27 |
| 1124628425 | Lakesha Tate | Case Manager/Care Coordinator | 200 12th Street Ext, Princeton, WV 24740-2329 | 2020-10-27 |
| 1376154617 | Patricia Bolen | Case Manager/Care Coordinator | 200 12th Street Ext, Princeton, WV 24740-2329 | 2020-08-11 |
| 1821607227 | Aaron Zane Pettrey | Case Manager/Care Coordinator | 200 12th Street Ext, Princeton, WV 24740-2329 | 2020-07-31 |
| 1487263133 | Haley Brianne Thompson | Social Worker | 200 12th Street Ext, Princeton, WV 24740-2329 | 2020-07-29 |
| 1881203008 | Lakie Elizabeth Delida | Case Manager/Care Coordinator | 200 12th Street Ext, Princeton, WV 24740-2329 | 2020-07-23 |
| 1992313613 | Michael Edwin Lewis | Case Manager/Care Coordinator | 200 12th Street Ext, Princeton, WV 24740-2329 | 2020-07-20 |
| 1912520677 | Krystal Rose Carver | Case Manager/Care Coordinator | 200 12th Street Ext, Princeton, WV 24740-2329 | 2020-05-28 |
| 1538796511 | Linda S Smith | Case Manager/Care Coordinator | 200 12th Street Ext, Princeton, WV 24740-2329 | 2020-03-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427658632 | New Beginnings Therapy Services, LLC | Community/Behavioral Health | 616 Harrison Street, Princeton, WV 24740 | 2020-10-27 |
| 1215536222 | Right At Home | Home Health | 313 Locus St, Princeton, WV 24740 | 2020-10-21 |
| 1881208098 | Robin Lane | Technician | 174 Tea Kettle Road, Princeton, WV 24740 | 2020-09-04 |
| 1134739824 | Nona Arthur | Technician | 708 Bluefiled Ave, Princeton, WV 24740 | 2020-08-06 |
| 1851909014 | Tina B Altizer | Speech-Language Pathologist | 120 12th Street, Princeton, WV 24740 | 2020-07-14 |
| 1245712504 | Tracy Jean Mitchell | Speech-Language Pathologist | 1200 Mercer St, Princeton, WV 24740 | 2018-09-04 |
| 1700305240 | Tina Six | Registered Nurse | 1403 Honaker Avenue, Princeton, WV 24740 | 2017-09-15 |
| 1013449172 | Karin Cappa | Pharmacist | 669 Cornfield Rd, Princeton, WV 24740 | 2017-03-29 |
| 1942661723 | Virginia Chryssikos | Social Worker | 3016 E Cumberland Road, Bluestone Family Practice, Bluefield, WV 24740 | 2016-03-08 |
| 1477939460 | Kathy Diane Wyrick | Counselor | 220 South Walker Street, Princeton, WV 24740 | 2015-08-03 |
| Find all providers in zip 24740 | ||||
| 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 |
|---|---|---|---|---|
| 1639708464 | Thirumala Group LLC | Pharmacy | 100 W Princeton Dr Ste A, Princeton, TX 75407-9607 | 2020-04-03 |
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| 1407290224 | Uniqcare Pharmacy | Pharmacy | 3538 Teays Valley Rd, Hurricane, WV 25526-9054 | 2013-04-23 |
| 1588987051 | Medical Park Pharmacy Ltc Inc | Pharmacy | 4118 5th Street Rd, Huntington, WV 25701-9547 | 2010-03-11 |
| 1326159419 | Home Care Pharmacy LLC | Pharmacy | 125 Lakeview Dr Ste G, Cross Lanes, WV 25313-4414 | 2006-08-31 |
| 1124030366 | Anile Pharmacy Inc | Pharmacy | 2413 Pennsylvania Ave, Weirton, WV 26062-3632 | 2006-08-13 |
| 1508876640 | Compass Health Services, LLC | Pharmacy | 102 Corporate Dr, Morgantown, WV 26501-4580 | 2006-08-09 |
| 1245275551 | Continuumcare Pharmacy LLC | Pharmacy | 78 Perry Winkle Ln, Huntington, WV 25702-9506 | 2006-06-19 |
| 1295739654 | Judys Drug Store Inc | Pharmacy | 24 N Main St, Petersburg, WV 26847-1518 | 2005-06-13 |
| 1083617799 | Follansbee Pharmacy Inc | Pharmacy | 651 Colliers Way, Suite 204, Weirton, WV 26062-5053 | 2005-05-27 |
| 1275134330 | Griffith and Feil Drug, Inc | Pharmacy | 1405 Chestnut St, Kenova, WV 25530-1235 | 2020-11-05 |
| 1093327272 | Community Prescription Center Inc | Pharmacy | 124 Main St, Man, WV 25635-1212 | 2020-08-19 |
| 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.