GENOA HEALTHCARE, LLC (NPI# 1962928093) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962928093 |
| Entity Type | Organization |
| Organization Name | GENOA HEALTHCARE, LLC |
| Practice Address |
56 Coventry St Ste B Hartford CT 06112-1524 |
| Mailing Address |
18300 Cascade Ave S Ste 251 Tukwila WA 98188-4746 |
| Practice Telephone | 8609673116 |
| Practice Fax Number | 8602449212 |
| Mailing Telephone | 2532180830 |
| Enumeration Date | 2017-08-21 |
| Last Update Date | 2020-03-11 |
| 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 | 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 |
| 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 |
56 COVENTRY ST STE B |
| City | HARTFORD |
| State | CT |
| Zip Code | 06112-1524 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841810355 | Ashwin Mahesh | Student in an Organized Health Care Education/Training Program | 131 Coventry Street, 2nd Floor, Burgdorf Clinic, Hartford, CT 06112 | 2020-04-24 |
| 1336600527 | Waleed Ibrahim | Student in an Organized Health Care Education/Training Program | Burgdorf Clinic, 131 Coventry Street 2nd Floor, Hartford, CT 06112 | 2019-03-29 |
| 1740741941 | Hajra Munawar | Student in an Organized Health Care Education/Training Program | Burgdorf Clinic 131 Coventry Street, Hartford, CT 06112 | 2019-03-29 |
| 1194191973 | Esther Wint | Nurse Practitioner | 490 Blue Ave, Hartford, CT 06112 | 2015-08-17 |
| 1194105700 | Michelle Russi | Physical Therapy Assistant | 490 Blue Hill Ave., Hartford, CT 06112 | 2015-06-09 |
| 1366858359 | Krysten N Marotta | Pharmacist | 1290 Albany Ave, Hartford, CT 06112 | 2014-07-10 |
| 1447403522 | Moon Hee Yoo | Psychiatry & Neurology | 500 Vine St., Capitol Region Mental Health Center, Hartford, CT 06112 | 2008-11-03 |
| 1992958094 | Roxann Marie Ellis-denby | Social Worker | 51 Coventry Street, Capitol Region Mental Health Center, Hartford, CT 06112 | 2008-11-03 |
| 1265590871 | The Connecticut Institute for The Blind | Intermediate Care Facility, Mentally Retarded | 120 Holcomb Street, Hartford, CT 06112 | 2006-12-05 |
| 1164580379 | Intercommunity, Inc. | Clinic/Center | 16 Coventry Street, Hartford, CT 06112 | 2006-12-04 |
| Find all providers in zip 06112 | ||||
| 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 |
|---|---|---|---|---|
| 1629077912 | Arrow Prescription Center 14 Inc | Pharmacy | 100 Woodland St, Hartford, CT 06105-1223 | 2005-07-19 |
| 1609346576 | Ssv Pharmacy 1 | Pharmacy | 500 Farmington Ave, Hartford, CT 06105-3106 | 2018-12-04 |
| 1033687561 | Health Care LLC | Pharmacy | 740 Maple Ave, Hartford, CT 06114-2314 | 2018-11-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447898523 | Beacon Pharmacy LLC | Pharmacy | 42 Windsor Ave, Vernon, CT 06066-2438 | 2019-12-19 |
| 1740658889 | Evine LLC | Pharmacy | 54 Tuttle Pl, Middletown, CT 06457-1863 | 2015-09-07 |
| 1992189146 | Wassef LLC | Pharmacy | 535 Boston Post Rd, Old Saybrook, CT 06475-1506 | 2015-07-17 |
| 1558704072 | Care 4 U Pharmacy, Inc. | Pharmacy | 216 Christian Ln, Suite B, Berlin, CT 06037-1450 | 2013-04-15 |
| 1609095868 | Danielson Pharmacy Inc | Pharmacy | 77 A Westcott Rd, Danielson, CT 06239 | 2007-04-25 |
| 1881791093 | Value Healthcare Services LLC | Pharmacy | 525 Knotter Dr, Cheshire Industrial Park, Cheshire, CT 06410-1100 | 2006-09-20 |
| 1851401814 | James L. Trifiro | Pharmacy | 1300 Hopmeadow St, Simsbury, CT 06070-1411 | 2006-08-30 |
| 1336170349 | Partners of Connecticut, LLC | Pharmacy | 6 Thompson Rd, East Windsor, CT 06088-9626 | 2006-07-06 |
| 1780689836 | Masonic Healthcare Center | Pharmacy | 22 Masonic Ave, Wallingford, CT 06492-3048 | 2005-06-16 |
| 1124636469 | Nutmeg Pharmacy Moodus LLC | Pharmacy | 38 William F Palmer Rd, Moodus, CT 06469-1131 | 2020-07-22 |
| 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.