GENOA HEALTHCARE, LLC (NPI# 1659668598) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659668598 |
| Entity Type | Organization |
| Organization Name | GENOA HEALTHCARE, LLC |
| Practice Address |
3101 Old Highway 8 Ste 203b Roseville MN 55113-1077 |
| Mailing Address |
Po Box 77030 Minneapolis MN 55480-7730 |
| Practice Telephone | 6123269225 |
| Practice Fax Number | 6516978315 |
| Mailing Telephone | 2532180830 |
| Mailing Fax Number | 2532174306 |
| Enumeration Date | 2011-06-29 |
| Last Update Date | 2020-03-20 |
| 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 | 332B00000X | Durable Medical Equipment & Medical Supplies | 1703-43 | WI | Suppliers |
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
264657 | MN | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2130937 | 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 |
| Street Address |
3101 OLD HIGHWAY 8 STE 203B |
| City | ROSEVILLE |
| State | MN |
| Zip Code | 55113-1077 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184627804 | Julie A Jackman | Pharmacist | 3101 Old Highway 8 Ste 203b, Roseville, MN 55113-1077 | 2005-05-27 |
| 1467005371 | Kristi Sharp | Pharmacist | 3101 Old Highway 8 Ste 203b, Roseville, MN 55113-1077 | 2019-07-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396384376 | Zachary Mattson | Physician Assistant | Regus Coworking Space 2355 Highway 36 West, Suite 400, Office #427, Roseville, MN 55113 | 2019-12-23 |
| 1467010330 | Ahmed Issa | Student in an Organized Health Care Education/Training Program | 1550 Larpenteur Ave W, Apt 235, St Paul, MN 55113 | 2019-06-05 |
| 1821653833 | Suite Living Senior Care of Little Canada | Assisted Living Facility | 2740 Rice Street, Little Canada, MN 55113 | 2019-05-06 |
| 1902370505 | Diverse Assessments and Treatment, LLC | Psychologist | 1935 Cty Rd B2 W Ste 270, Roseville, MN 55113 | 2019-01-16 |
| 1588138473 | Applewood Home Health Care, LLC | Home Health | 2021 E Hennepin Avenue # 402-1, Minneapolis, MN 55113 | 2019-01-14 |
| 1699251520 | Optum Infusion Services 500, Inc. | Durable Medical Equipment & Medical Supplies | 2685 Patton Rd, Roseville, MN 55113 | 2018-07-13 |
| 1083104145 | Suite Living Senior Care of Roseville | Assisted Living Facility | 197 County Road B2 W, Roseville, MN 55113 | 2018-05-15 |
| 1477055796 | Sunrise Residential Services LLC | Home Health | 216 Maple Ln, Roseville, MN 55113 | 2018-03-02 |
| 1194223024 | Alissa Hoff | Specialist | 1595 Mn 36 - 584 10 Rosedale Center, Roseville, MN 55113 | 2018-01-25 |
| 1841705118 | Kingsland Care Services Incorporated | Case Management | 2301 Rice Street, Suite 101, Roseville, MN 55113 | 2017-12-08 |
| Find all providers in zip 55113 | ||||
| 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 |
|---|---|---|---|---|
| 1588170823 | Elwaseem-toor LLC | Pharmacy | 16970 E 13 Mile Rd Ste A, Roseville, MI 48066-7719 | 2017-12-22 |
| 1306366950 | Cgm Pharmacy Corporation | Pharmacy | 1340 Blue Oaks Blvd Ste 110, Roseville, CA 95678-7038 | 2017-06-26 |
| 1528693603 | Remedyrx Pharmacy | Pharmacy | 1420 E Roseville Pkwy Ste 130, Roseville, CA 95661-3081 | 2020-03-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114544822 | Rolseth Drug Co | Pharmacy | 26709 Forest Blvd, Wyoming, MN 55092-8022 | 2020-06-29 |
| 1962037242 | United Community Pharmacy Corporation | Pharmacy | 2500 Highway 88 Ste 105, St Anthony, MN 55418-4138 | 2020-03-07 |
| 1629613005 | Lotus Ltc Pharmacy, LLC | Pharmacy | 9850 51st Ave N Ste 102, Plymouth, MN 55442-3271 | 2019-11-09 |
| 1720541337 | Ltc Prescription Providers #2 | Pharmacy | 220 1/2 Third Avenue, Proctor, MN 55810 | 2019-04-10 |
| 1639634710 | Lewis Family Drug, LLC | Pharmacy | 1105 13th Ave S, Saint James, MN 56081 | 2019-02-04 |
| 1033680046 | Brainerd Medical Center Inc | Pharmacy | 280 Barclay Ave W, Ste 1100, Pine River, MN 56474 | 2018-12-17 |
| 1457832909 | Black Forest Pharmacy Services Ltd | Pharmacy | 108 S 6th St Ste 1, Brainerd, MN 56401-3594 | 2018-08-23 |
| 1467932905 | Watertown Pharmacy LLC | Pharmacy | 204 Lewis Ave S Ste 101, Watertown, MN 55388-4501 | 2018-08-15 |
| 1942702394 | Polaris Pharmacy Services of Minnesota, LLC | Pharmacy | 4220 Park Glen Road, St. Louis Park, MN 55416 | 2018-03-01 |
| 1346757457 | Twin Valley Pharmacy LLC | Pharmacy | 108 Viking Ave W., Ulen, MN 56585 | 2018-01-10 |
| 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.