GENOA HEALTHCARE, LLC (NPI# 1750792248) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750792248 |
| Entity Type | Organization |
| Organization Name | GENOA HEALTHCARE, LLC |
| Practice Address |
4105 Kirkman St Lake Charles LA 70607-4603 |
| Mailing Address |
Po Box 77030 Minneapolis MN 55480-7730 |
| Practice Telephone | 3374260906 |
| Practice Fax Number | 3375644143 |
| Mailing Telephone | 2532180830 |
| Mailing Fax Number | 2532174306 |
| Enumeration Date | 2014-05-19 |
| Last Update Date | 2020-03-17 |
| 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 | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
PHY006891RC | LA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2145662 | 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 |
| Street Address |
4105 KIRKMAN ST |
| City | LAKE CHARLES |
| State | LA |
| Zip Code | 70607-4603 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578517439 | Craig D. Waggoner | Psychologist | 4105 Kirkman St, Lake Charles, LA 70607-4603 | 2006-05-22 |
| 1659988343 | Katie Bruce | Pharmacist | 4105 Kirkman St, Lake Charles, LA 70607-4603 | 2020-09-26 |
| 1598245623 | Imperial Calcasieu Human Services Authority | Clinic/Center | 4105 Kirkman St, Lake Charles, LA 70607-4603 | 2018-08-17 |
| 1730698838 | Rebecca Becky Perry | Social Worker | 4105 Kirkman St, Lake Charles, LA 70607-4603 | 2017-09-21 |
| 1538566336 | Troy Barrow | Registered Nurse | 4105 Kirkman St, Lake Charles, LA 70607-4603 | 2014-11-24 |
| 1992101240 | Clint Dupre | Licensed Practical Nurse | 4105 Kirkman St, Lake Charles, LA 70607-4603 | 2014-11-14 |
| 1386057891 | Vicki Ann Lebleu | Nurse Practitioner | 4105 Kirkman St, Lake Charles, LA 70607-4603 | 2014-06-03 |
| 1376971200 | Lexi Berryhill | Social Worker | 4105 Kirkman St, Lake Charles, LA 70607-4603 | 2013-11-01 |
| 1700127487 | Dana Young | Counselor | 4105 Kirkman St, Lake Charles, LA 70607-4603 | 2013-03-06 |
| 1730420530 | Sandy Marie Faulk | Counselor | 4105 Kirkman St, Lake Charles, LA 70607-4603 | 2013-03-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710596283 | Dakota Loosemore | Student in an Organized Health Care Education/Training Program | 800 East Mcneese Street, Lake Charles, LA 70607 | 2020-07-30 |
| 1467003822 | Sarah Jane Walley | Specialist/Technologist | 800 E Mcneese Street, Lake Charles, LA 70607 | 2019-09-26 |
| 1770053902 | Antonio Rivera | Chiropractor | 2625 Dillard Loop, Suite C, Lake Charles, LA 70607 | 2018-11-30 |
| 1851861330 | Shannon Marie Melvin | Specialist/Technologist | 800 East Mcneese, Lake Charles, LA 70607 | 2018-11-28 |
| 1326517699 | Vincent Michael Williams | Specialist/Technologist | 800 East Mcneese St, Lake Charles, LA 70607 | 2018-11-16 |
| 1396263356 | Lake Area Physician Services LLC | Durable Medical Equipment & Medical Supplies | 10071 Hwy 385, Lake Charles, LA 70607 | 2017-08-30 |
| 1023556370 | Heath Bryan Coleman, Dds of Louisiana II, A Professional Dental LLC | Dentist | 2625 Dillard Loop, Ste A, Lake Charles, LA 70607 | 2017-02-07 |
| 1750741880 | Townsend Treatment Center, LLC | Substance Abuse Rehabilitation Facility | 635a Petro Point Dr, Lake Charles, LA 70607 | 2016-03-02 |
| 1194081414 | Clint Nickolas Lincoln | Family Medicine | 10071 Gulf Hwy, Lake Charles, LA 70607 | 2012-04-11 |
| 1295976652 | John Leroy Speer | Dentist | 3425 Louisiana Ave., Lake Charles, LA 70607 | 2009-03-16 |
| Find all providers in zip 70607 | ||||
| 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 |
|---|---|---|---|---|
| 1942307780 | Thrifty Way of Lake Charles, Inc | Pharmacy | 1001 3rd Avenue, Lake Charles, LA 70601 | 2006-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437700549 | Neighbors Pharmacy | Pharmacy | 6770 Johnston St Ste A, Lafayette, LA 70503-6202 | 2019-09-20 |
| 1578111613 | Parkers Pharmacy LLC | Pharmacy | 9600 Florida Blvd Ste 5, Baton Rouge, LA 70815-1110 | 2019-09-02 |
| 1487119079 | Mer Rouge Family Pharmacy, LLC | Pharmacy | 316 Davenport Ave, Mer Rouge, LA 71261-9720 | 2019-02-07 |
| 1689148264 | Healthy Solutions Pharmacy & Medical Supplies | Pharmacy | 600 E Judge Perez Dr, Chalmette, LA 70043-5201 | 2019-01-16 |
| 1124578927 | Hardys Drug Store Inc | Pharmacy | 123 Fuselier Rd, Arnaudville, LA 70512-6134 | 2016-10-05 |
| 1306268297 | Valentine Long Term Care LLC | Pharmacy | 407 Polk St, Mansfield, LA 71052-2405 | 2014-01-10 |
| 1023354644 | Care Rx Inc | Pharmacy | 2400 Church Point Hwy, Rayne, LA 70578-7661 | 2012-12-31 |
| 1124375282 | National Pharmacy Acquisition LLC | Pharmacy | 3202 W Metairie Ave S, Metairie, LA 70001-5235 | 2012-08-08 |
| 1780957928 | Genoa Healthcare, LLC | Pharmacy | 2751 Wooddale Blvd Ste D, Baton Rouge, LA 70805-7567 | 2012-02-20 |
| 1720359599 | Pharmacy Alternatives, LLC | Pharmacy | 190 James Dr E, Suite 130, Saint Rose, LA 70087-4056 | 2012-01-25 |
| Find all providers with the same taxonomy | ||||
| City | LAKE CHARLES |
| Zip Code | 70607 |
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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.