GENOA HEALTHCARE, LLC (NPI# 1053630558) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053630558 |
| Entity Type | Organization |
| Organization Name | GENOA HEALTHCARE, LLC |
| Practice Address |
515 Bayou St Vincennes IN 47591-1034 |
| Mailing Address |
Po Box 77030 Minneapolis MN 55480-7730 |
| Practice Telephone | 8128860907 |
| Practice Fax Number | 8128860951 |
| Mailing Telephone | 2532180830 |
| Mailing Fax Number | 2532174306 |
| Enumeration Date | 2010-05-24 |
| Last Update Date | 2020-03-26 |
| 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 |
|---|---|---|---|---|---|
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
60006461A | IN | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2125102 | 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 |
515 BAYOU ST |
| City | VINCENNES |
| State | IN |
| Zip Code | 47591-1034 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639176373 | Good Samaritan Hospital | Counselor | 515 Bayou St, Vincennes, IN 47591-1034 | 2005-07-07 |
| 1922625417 | Linda Goodwin | Social Worker | 515 Bayou St, Vincennes, IN 47591-1034 | 2020-06-30 |
| 1508411695 | Caryn Miller | Specialist | 515 Bayou St, Vincennes, IN 47591-1034 | 2019-08-06 |
| 1124672829 | Leah Shan | Pharmacist | 515 Bayou St, Vincennes, IN 47591-1034 | 2019-07-31 |
| 1205390689 | Ashley J Gonzalez | Social Worker | 515 Bayou St, Vincennes, IN 47591-1034 | 2019-01-30 |
| 1982186284 | Amy L Dunbar | Nurse Practitioner | 515 Bayou St, Vincennes, IN 47591-1034 | 2018-09-04 |
| 1790261998 | Bobbie Davis | Social Worker | 515 Bayou St, Vincennes, IN 47591-1034 | 2018-07-11 |
| 1609360825 | Eden Daugherty | Specialist | 515 Bayou St, Vincennes, IN 47591-1034 | 2018-06-20 |
| 1972097194 | Hayley Hamm | Specialist | 515 Bayou St, Vincennes, IN 47591-1034 | 2018-06-20 |
| 1396239505 | Dawn Stroud | Specialist | 515 Bayou St, Vincennes, IN 47591-1034 | 2018-06-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720688484 | Mary Alsakka | Pharmacist | 602 Kimmell Rd, Vincennes, IN 47591 | 2020-10-30 |
| 1265053854 | Hamilton Center Inc. | Clinic/Center | 1433 Willow Street, Vincennes, IN 47591 | 2020-05-05 |
| 1134690654 | Deaconess Hospital Inc | Durable Medical Equipment & Medical Supplies | 516 S. 9th St, Vincencces, IN 47591 | 2018-12-10 |
| 1730612698 | Advanced Pain Care Clinic Psc | Pain Medicine | 1813 Willow St Ste 3b, Vincennes, IN 47591 | 2017-04-07 |
| 1033566203 | Jennifer Hoyt | Nurse Practitioner | 1813 Willow St Ste 3a, Vincennes, IN 47591 | 2016-05-18 |
| 1821469602 | Riverside Family Clinic, Inc | Nurse Practitioner | 328 N 2nd St, Suite 102, Vincennes, IN 47591 | 2015-10-19 |
| 1902205594 | Kathleen Garner | Physical Therapy Assistant | 3901 Old Bruceville Road, Vincennes, IN 47591 | 2014-08-19 |
| 1467703645 | Molly Ann Barth | Speech-Language Pathologist | 3801 Old Bruceville Road, Vincennes, IN 47591 | 2012-09-27 |
| 1083965776 | Tiffany Renee Neukam | Occupational Therapist | 1900 College Ave., Vincennes, IN 47591 | 2012-09-21 |
| 1396057089 | Jericho Lynn Quick | Optometrist | 1813 Willow St Ste 2a, Vincennes, IN 47591 | 2010-07-09 |
| Find all providers in zip 47591 | ||||
| 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] |
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| 1669030102 | Meds To You LLC | Pharmacy | 8250 Bash St Ste A3, Indianapolis, IN 46250-1938 | 2019-05-30 |
| 1083188973 | Circle City Pharmacy, LLC | Pharmacy | 65 E Garner Rd Ste 200, Brownsburg, IN 46112-7867 | 2019-01-14 |
| 1174091557 | Rubicon Dtp, LLC | Pharmacy | 5751 W 73rd St # A, Indianapolis, IN 46278-1741 | 2018-11-05 |
| 1962870295 | Pca Corrections LLC | Pharmacy | 1740 Williamsburg Dr Ste A, Jeffersonville, IN 47130-8066 | 2015-09-03 |
| 1407235013 | Cppltc LLC | Pharmacy | 482 W Navajo St Ste B, West Lafayette, IN 47906-1940 | 2015-05-28 |
| 1871986596 | N&m Investments | Pharmacy | 30 S Water St Ste B, Franklin, IN 46131-2316 | 2015-03-05 |
| 1588911895 | United Rx, LLC | Pharmacy | 2325 Pointe Pkwy, Carmel, IN 46032-3294 | 2012-08-07 |
| 1265674097 | Pauls Pharmacy Inc | Pharmacy | 4111 N Saint Joseph Ave, Evansville, IN 47720-1206 | 2009-03-25 |
| 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.