GENOA HEALTHCARE, LLC (NPI# 1912507211) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912507211 |
| Entity Type | Organization |
| Organization Name | GENOA HEALTHCARE, LLC |
| Practice Address |
5690 Santa Teresita Drive, Suite A2, Room P1 Santa Teresa NM 88008 |
| Mailing Address |
Po Box 77030 Minneapolis MN 55480-7730 |
| Practice Telephone | 2532180830 |
| Practice Fax Number | 2532174306 |
| Mailing Telephone | 2532180830 |
| Mailing Fax Number | 2532174306 |
| Enumeration Date | 2020-10-27 |
| Last Update Date | 2020-10-29 |
| 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 | Suppliers | ||
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
Suppliers |
| 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 |
| 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 |
| 1740893973 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 3612 Pera Ave Ste P1, El Paso, TX 79905-2412 | 2020-08-27 |
| 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 |
5690 SANTA TERESITA DRIVE, SUITE A2, ROOM P1 |
| City | SANTA TERESA |
| State | NM |
| Zip Code | 88008 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891848131 | Direct Healthcare South Inc | Home Health | 101 Livingston Loop, Suite 5, Santa Teresa, NM 88008 | 2007-01-19 |
| 1912061235 | Rio Valle Behavioral Health Centre | Psychiatry & Neurology | 101 Livinston Loop, Bldg C Suite 3, Santa Teresa, NM 88008 | 2006-12-21 |
| 1679634562 | Robert L Nichols | Family Medicine | 1300 Country Club Road, Santa Teresa, NM 88008 | 2006-12-13 |
| 1881792950 | Leo J Raschbaum Mdpc | Clinic/Center | 5690 Santa Teresita, Building A, Suite 4, Santa Teresa, NM 88008 | 2006-09-20 |
| 1366410276 | Emilio T. Rivera | Anesthesiology | 5290 Mcnutt Rd, Ste 109, Santa Teresa, NM 88008 | 2006-03-08 |
| 1225486194 | Diane Rivera | Registered Nurse | 101 Airport Road, Santa Teresa, NM 88008 | 2016-06-01 |
| 1780080358 | Audriana Apodaca | Nurse Practitioner | 100 Airport Rd, Santa Teresa, NM 88008 | 2014-11-10 |
| 1447667001 | Noha Oushy Eissa | Dentist | 103 Livingston Loop Ste B3, Santa Teresa, NM 88008 | 2014-07-16 |
| 1871963017 | Oralia Quezada | Student in an Organized Health Care Education/Training Program | 103 Livingston Loop, Bldg B, Suite 4, Santa Teresa, NM 88008-1063 | 2015-09-30 |
| 1730742388 | Myriam Yvonne Frias | Nurse Practitioner | 5290 Mcnutt Rd, Santa Teresa, NM 88008-1590 | 2019-04-18 |
| Find all providers in zip 88008 | ||||
| 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 |
|---|---|---|---|---|
| 1922579705 | Mesilla Valley Pharmacy & Consulting | Pharmacy | 100 Wyatt Dr Ste B, Las Cruces, NM 88005-2922 | 2018-12-05 |
| 1669954798 | Zia Pharmacy, LLC | Pharmacy | 575 S Alameda Blvd Ste 102, Las Cruces, NM 88005-2818 | 2018-09-05 |
| 1558859710 | Integral Pharmacy, LLC | Pharmacy | 109 S Second St, Gallup, NM 87301-6219 | 2018-04-24 |
| 1740659150 | State of New Mexico | Pharmacy | 41 Fort Bayard Rd, Santa Clara, NM 88026 | 2015-09-16 |
| 1730585142 | Zia Pharmacy, LLC | Pharmacy | 2820 Broadbent Pkwy Ne Ste C, Albuquerque, NM 87107-1621 | 2014-11-12 |
| 1902169816 | Badger Health Corp | Pharmacy | 1275 S 2nd St Ste A, Raton, NM 87740-2209 | 2012-06-18 |
| 1356364343 | May Pharmacy Cedar Crest Inc | Pharmacy | 12129 Hwy 14 N, Cedar Crest, NM 87008-9492 | 2006-07-25 |
| 1386679710 | Ncs Healthcare of New Mexico, LLC | Pharmacy | 9019 Washington St Ne, Suite B1, Albuquerque, NM 87113-2435 | 2006-07-12 |
| 1245239185 | Mjrx II LLC | Pharmacy | 1445 Wyoming Blvd Ne, Albuquerque, NM 87112-3849 | 2005-07-20 |
| 1760018212 | Pharmex Inc | Pharmacy | 2300 E 30th St Ste B-101, Farmington, NM 87401-8991 | 2020-03-17 |
| Find all providers with the same taxonomy | ||||
| City | SANTA TERESA |
| Zip Code | 88008 |
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.