GENOA HEALTHCARE, LLC (NPI# 1699035899) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699035899 |
| Entity Type | Organization |
| Organization Name | GENOA HEALTHCARE, LLC |
| Practice Address |
1977 Niles Rd Se Warren OH 44484-5118 |
| Mailing Address |
Po Box 77030 Minneapolis MN 55480-7730 |
| Practice Telephone | 3309807037 |
| Practice Fax Number | 3303691229 |
| Mailing Telephone | 2532180830 |
| Mailing Fax Number | 2532174306 |
| Enumeration Date | 2012-05-22 |
| Last Update Date | 2020-03-26 |
| 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 |
PMY.022212150-03 | OH | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2134941 | 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 |
1977 NILES RD SE |
| City | WARREN |
| State | OH |
| Zip Code | 44484-5118 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750493029 | Christopher Brian Mccord | Dentist | 1977 Niles Rd Se, Warren, OH 44484-5118 | 2006-08-31 |
| 1871051037 | Allison Bottorff | Nurse Practitioner | 1977 Niles Rd Se, Warren, OH 44484-5118 | 2019-03-06 |
| 1831466549 | Christopher Matthew Broderick | Nurse Practitioner | 1977 Niles Rd Se, Warren, OH 44484-5118 | 2011-11-23 |
| 1942504089 | Ohio North East Health Systems, Inc | Counselor | 1977 Niles Rd Se, Warren, OH 44484-5118 | 2011-01-04 |
| 1033437702 | Ohio North East Health Systems, Inc | Family Medicine | 1977 Niles Rd Se, Warren, OH 44484-5118 | 2010-05-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205446283 | Jessica Toot | Behavior Technician | Oakwood Counseling Center LLC, 1704 North Road Se, Warren, OH 44484 | 2020-08-05 |
| 1558857060 | Quantina Louise Thomas | Home Health | 1548oak Knoll Se, Warren, OH 44484 | 2018-07-09 |
| 1033609706 | Justin A Houy | Massage Therapist | 8345 E. Market St. Suite C, The Chiropractic and Functional Neurology Center, Warren, OH 44484 | 2018-05-17 |
| 1679091359 | Ester Mae Butler | Nurse's Aide | 2228 Draper Avenue Se, Warren, OH 44484 | 2017-09-01 |
| 1477070811 | Amanda Lynn Heberling | Occupational Therapy Assistant | 8128 Kenyon Dr., Warren, OH 44484 | 2017-08-26 |
| 1790213650 | Joyce A Mechling | Licensed Practical Nurse | 2737 Youngstown Rd., Warren, OH 44484 | 2017-05-23 |
| 1598206898 | Stan Catullo | Substance Abuse Rehabilitation Facility | 2737 Youngstown Warren Road Se, Warren, OH 44484 | 2017-03-20 |
| 1679014054 | Pamela M Lang | Pharmacist | 1977 Niles Rd S.e., Genoa A Qol Healthcare Company, Warren, OH 44484 | 2017-03-17 |
| 1922454800 | Jeremy Michael Capetillo | Dentist | 8740 E Market St Ste 1, Warren, OH 44484 | 2016-05-10 |
| 1215311865 | Jessica Dawn Harris | Physical Therapy Assistant | 1926 Ridge Avenue, Warren, OH 44484 | 2015-07-14 |
| Find all providers in zip 44484 | ||||
| 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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| 1124102264 | Walgreen Co | Pharmacy | 310 S Martin St, Warren, AR 71671-2818 | 2006-10-25 |
| 1093823460 | Great Lakes Pharmacies I Inc | Pharmacy | 6213 Chicago Rd Suite 200, Warren, MI 48092 | 2006-08-27 |
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| 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 | ||||
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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.