GENOA HEALTHCARE, LLC (NPI# 1962929505) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962929505 |
| Entity Type | Organization |
| Organization Name | GENOA HEALTHCARE, LLC |
| Other Organization Name | GENOA HEALTHCARE |
| Practice Address |
1441 W Central Park Ave Ste 53 Davenport IA 52804-1707 |
| Mailing Address |
Po Box 77030 Minneapolis MN 55480-7730 |
| Practice Telephone | 5632656955 |
| Practice Fax Number | 5632753296 |
| Mailing Telephone | 2532180830 |
| Mailing Fax Number | 2532174306 |
| Enumeration Date | 2017-08-24 |
| Last Update Date | 2020-03-05 |
| 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 | 333600000X | Pharmacy | Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
1630 | IA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2175736 | 01 | |
| IA | 0711082 | 05 |
| Other Name | Type Code |
|---|---|
| Genoa Healthcare | Doing Business As Name - Organization |
| 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 |
| Connecticut Business Registrations | GENOA HEALTHCARE, LLC | 18300 Cascade Avenue South, Suite 251, Tukwila, WA 98188 |
| Street Address |
1441 W CENTRAL PARK AVE STE 53 |
| City | DAVENPORT |
| State | IA |
| Zip Code | 52804-1707 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265948467 | Tess Nelson | Physical Medicine & Rehabilitation | 2535 Maplecrest Rd Suite 23, Bettendorf, IA 52804 | 2017-12-26 |
| 1124494380 | Erica Lauren Hempel Bucy | Social Worker | 1333 W. Lombard St. Ste C, Davenport, IA 52804 | 2015-08-11 |
| 1477859890 | Kristin L West | Registered Nurse | 1441 W. Centrral Park Ave, Vera French Community Mental Health Center, Davenport, IA 52804 | 2011-02-02 |
| 1679877625 | Linda Marie Crownover-inch | Doula | 1420 W 16th Street, #412, Davenport, IA 52804 | 2011-01-05 |
| 1124169032 | Lawrence R Huber | Dentist | 2305 Jersey Ridge Rd, Davenport, IA 52804 | 2007-02-12 |
| 1669532388 | Providence Therapy Services LLC | Physical Therapist | 21037 Holden Drive, Davenport, IA 52804 | 2006-12-11 |
| 1639183171 | Megan Denise Long | Occupational Therapist | 31037 Holden Dr, Davenport, IA 52804 | 2006-07-28 |
| 1811919772 | Theresa L Schlabach | Occupational Therapist | 21037 Holden Dr, Davenport, IA 52804 | 2006-07-23 |
| 1225097843 | William M Nissen | Psychiatry & Neurology | 1441 W Central Park, Davenport, IA 52804 | 2006-03-22 |
| 1245721851 | Mackenzie J Banwart | Physical Therapist | 1700 N Division St Ste 200, Davenport, IA 52804 | 2018-05-21 |
| Find all providers in zip 52804 | ||||
| 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 |
|---|---|---|---|---|
| 1851773501 | Community Pharmacy Services Inc | Pharmacy | 5217 Grand Ave, Davenport, IA 52807-1014 | 2015-06-18 |
| 1972683373 | Genventures, Inc. | Pharmacy | 1227 E Rusholme St, Davenport, IA 52803-2459 | 2006-10-17 |
| 1922040393 | Enloe Drugs, LLC | Pharmacy | 2660 E 53rd St, Suite 1, Davenport, IA 52807-3873 | 2006-06-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144864950 | Pm Acquisition, LLC | Pharmacy | 4927 Maple Dr Ste 200, Pleasant Hill, IA 50327-2030 | 2019-11-05 |
| 1992348882 | Pharmscript of Ia LLC | Pharmacy | 2601 104th St Ste 300, Urbandale, IA 50322-3954 | 2019-10-23 |
| 1063070985 | Pm Acquisition, LLC | Pharmacy | 107 W Main St Ste B, Ottumwa, IA 52501-2542 | 2019-06-05 |
| 1720543812 | Greenfield Pharmacy LLC | Pharmacy | 202 Se Kent St Ste 1, Greenfield, IA 50849-1411 | 2019-02-04 |
| 1508339425 | Pm Acquisition, LLC | Pharmacy | 2039 Crossroads Blvd Ste B, Waterloo, IA 50702-4403 | 2019-01-03 |
| 1427533165 | Consultant Pharmacists Inc | Pharmacy | 714 Illinois St, Sidney, IA 51652-8027 | 2018-09-28 |
| 1912486226 | Gbank Health LLC | Pharmacy | 617 8th Ave Se Ste C, Cedar Rapids, IA 52401-2117 | 2018-08-08 |
| 1811475064 | Gbank Health LLC | Pharmacy | 876 Tanglefoot Ln, Bettendorf, IA 52722-1605 | 2018-07-31 |
| 1588175103 | L & M Pharmacy Care | Pharmacy | 2526 Glenn Ave, Sioux City, IA 51106-2768 | 2017-10-23 |
| 1609393917 | Lewis Family Drug, LLC | Pharmacy | 528 S 3rd St, Moville, IA 51039 | 2017-08-28 |
| 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.