GENOA HEALTHCARE, LLC (NPI# 1720468911) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720468911 |
| Entity Type | Organization |
| Organization Name | GENOA HEALTHCARE, LLC |
| Practice Address |
3450 Highway 80 W Rm 68 Jackson MS 39209 |
| Mailing Address |
Po Box 77030 Minneapolis MN 55480-7730 |
| Practice Telephone | 6018241667 |
| Practice Fax Number | 6018256347 |
| Mailing Telephone | 2532180830 |
| Mailing Fax Number | 2532174306 |
| Enumeration Date | 2015-06-03 |
| Last Update Date | 2020-03-13 |
| Authorized Official Name | WILLIAM GUPTAIL (COO) |
| Authorized Official Telephone | 2532180830 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
09098/1.1 | MS | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2154632 | 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 |
3450 HIGHWAY 80 W RM 68 |
| City | JACKSON |
| State | MS |
| Zip Code | 39209 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275152043 | Jay Richard Barnhart | Pharmacist | 3450 Highway 80 W Rm 68, Jackson, MS 39209-7201 | 2020-04-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235754995 | Oak Street Health Physicians Group of Mississippi, LLC | Family Medicine | 911 Ellis Ave, Jackson, MS 39209 | 2020-06-09 |
| 1760003594 | Phi Health, LLC | Ambulance | 582 Ramp Road, Suite C, Jackson, MS 39209 | 2020-05-04 |
| 1013302082 | Tiffany Griffin | Nurse Practitioner | 3450 Highway 80 West, Jackson, MS 39209 | 2015-04-06 |
| 1679961957 | Cassetta Shontae Mcgee | Emergency Medical Technician, Basic | 5326 Queen Eleanor Ln, Jackson, MS 39209 | 2015-01-08 |
| 1124381280 | Martin Solution | In Home Supportive Care | 917 West Ridge, Jackson, MS 39209 | 2012-06-22 |
| 1649533589 | Adrinnie M Martin | Contractor | 917 Westridge, Jackson, MS 39209 | 2012-06-15 |
| 1831423862 | Infinity House, Inc | In Home Supportive Care | 1042 Pecan Park Circle, Jackson, MS 39209 | 2009-09-23 |
| 1174751093 | Linda M Vance | Nurse Practitioner | 1000 Metrocenter Ste 105, Jackson, MS 39209 | 2009-06-30 |
| 1770729998 | Kim Hestle | Speech-Language Pathologist | 733 N. Flag Chapel Road, Jackson, MS 39209 | 2008-12-17 |
| 1225287139 | Ralph Wendell Mims | Community Health Worker | 3708 Kennebrew Road, Jackson, MS 39209 | 2008-09-16 |
| Find all providers in zip 39209 | ||||
| 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 |
|---|---|---|---|---|
| 1942314570 | Pharmaceutical Services Inc | Pharmacy | W209 N17321 Industrial Dr, Jackson, WI 53037-9389 | 2006-08-19 |
| 1326029448 | R.c.mcdonald Co Inc | Pharmacy | 1701 Charter St, Jackson, LA 70748-5927 | 2005-11-07 |
| 1063031698 | Ltc Leonard LLC | Pharmacy | 303 W Prospect St, Jackson, MI 49203-4113 | 2020-04-14 |
| 1366061475 | Fpj Inc | Pharmacy | 200 W Main St, Jackson, TN 38301-6114 | 2020-04-09 |
| 1609125376 | Ampharm, Inc. | Pharmacy | 45 Forest Cv, Jackson, TN 38301 | 2012-09-10 |
| 1972657179 | Teton County Hospital District | Pharmacy | 625 E Broadway Ave, Jackson, WY 83001-8642 | 2007-01-23 |
| 1811075336 | Jackson Pharmacy Inc | Pharmacy | 200 W Washington St, Jackson, MO 63755-1858 | 2006-11-01 |
| 1710063276 | W.a. Foote Memorial Hospital, Inc. | Pharmacy | 2200 Springport Rd, Jackson, MI 49202-1432 | 2006-10-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275143323 | Sartin's Discount Drugs, Inc | Pharmacy | 4300 15th St Ste 1, Gulfport, MS 39501-2524 | 2020-08-04 |
| 1952932212 | Magnolia Drugs Inc | Pharmacy | 1757 Highway 178 W Ste B, Myrtle, MS 38650-9233 | 2020-01-27 |
| 1538717459 | Square Drugs, LLC | Pharmacy | 126 Court Square, Charleston, MS 38921 | 2019-09-04 |
| 1609436674 | Thrift Drugs 2 | Pharmacy | 208 W Presley Blvd Ste B, Mccomb, MS 39648-5524 | 2019-06-20 |
| 1285135954 | Rocky L. Mcgarity, Inc. | Pharmacy | 103 W Frontage Rd Ste A, Lucedale, MS 39452-5836 | 2018-02-27 |
| 1144753823 | Quinn's Family Pharmacy, Inc | Pharmacy | 24944 Hwy 15, Union, MS 39365-1565 | 2017-04-10 |
| 1336520188 | Redimeds Pharmacy, LLC | Pharmacy | 3466 Mccullough Blvd Ste D-2, Belden, MS 38826-9468 | 2015-06-17 |
| 1497133391 | Mississippi Senior Care | Pharmacy | 144 S Thomas St Ste 101-1, Tupelo, MS 38801-5326 | 2015-05-11 |
| 1881001501 | North Sunflower Medical Center | Pharmacy | 860 N Oak Ave, Ruleville, MS 38771 | 2014-07-15 |
| 1821292731 | Tara Pharmacy | Pharmacy | 110 Metroplex Blvd, Suite H, Pearl, MS 39218 | 2007-06-13 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on GENOA HEALTHCARE, LLC.
| 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.