GENOA HEALTHCARE, LLC


Address: 3111 Electric Ave, Port Huron, MI 48060-8127
Phone: 8108245120

GENOA HEALTHCARE, LLC (NPI# 1497791313) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1497791313
Entity Type Organization
Organization Name GENOA HEALTHCARE, LLC
Other Organization Name GENOA-QOL HEALTHCARE
Practice Address 3111 Electric Ave
Port Huron
MI 48060-8127
Mailing Address Po Box 77030
Minneapolis
MN 55480-7730
Practice Telephone 8108245120
Practice Fax Number 8108245124
Mailing Telephone 2532180830
Mailing Fax Number 2532174306
Enumeration Date 2006-06-20
Last Update Date 2020-03-05
Authorized Official Name WILLIAM GUPTAIL (COO)
Authorized Official Telephone 2532180830
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 3336C0003X Pharmacy
Specialization: Community/Retail Pharmacy
Suppliers
N 332B00000X Durable Medical Equipment & Medical Supplies Suppliers
Y 3336L0003X Pharmacy
Specialization: Long Term Care Pharmacy
5301009897 MI Suppliers

Other Provider Identifier

State Issuer Identifier Type Code
PK 2167615 01
MI 1497791313 05

Other Provider/Organization Names

Other Name Type Code
Genoa-QoL Healthcare Doing Business As Name - Organization

Other Provider IDs and Locations

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

Other Data Sources

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

Office Location

Street Address 3111 ELECTRIC AVE
City PORT HURON
State MI
Zip Code 48060-8127

Providers in the same location

NPI Name Taxonomy Address Enumeration
1770184202 Camilla Smith Social Worker 3111 Electric Ave, Port Huron, MI 48060-8127 2020-11-02
1992312425 Ashley Renock Social Worker 3111 Electric Ave, Port Huron, MI 48060-8127 2020-09-29
1720695240 Danielle Marie Mitchell Social Worker 3111 Electric Ave, Port Huron, MI 48060-8127 2020-09-29
1417565995 Keith R Gilbert Peer Specialist 3111 Electric Ave, Port Huron, MI 48060-8127 2020-07-21
1710504998 Caitlin Griswold Peer Specialist 3111 Electric Ave, Port Huron, MI 48060-8127 2020-07-03
1508482951 Elisa Dooley Registered Nurse 3111 Electric Ave, Port Huron, MI 48060-8127 2020-06-22
1811513690 Skye L Paling Case Manager/Care Coordinator 3111 Electric Ave, Port Huron, MI 48060-8127 2020-06-17
1457976102 Kathryn Shaw Technician, Pathology 3111 Electric Ave, Port Huron, MI 48060-8127 2020-06-09
1518593003 Joy Daggett Case Manager/Care Coordinator 3111 Electric Ave, Port Huron, MI 48060-8127 2020-03-17
1033745666 Robert Edison Farrell Jr. Case Manager/Care Coordinator 3111 Electric Ave, Port Huron, MI 48060-8127 2020-03-15
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1740897297 Casey Edward Bicker Behavior Technician 3245 Keewahdin Rd; Fort Gratiot, Mi 48059, Port Huron, MI 48060 2020-09-29
1962032078 Brianne Salchert Peer Specialist 1170 Michigan Rd., Port Huron, MI 48060 2020-01-17
1982123006 Kenneth Shine Heuvelman Counselor 3522 Holland Park Ln, Port Huron, MI 48060 2017-09-11
1346767506 Kelly Baker Social Worker 520 Superior St., Port Huron, MI 48060 2017-08-28
1326418609 Jean Burleigh Chore Provider 614 Staton, Port Huron, MI 48060 2015-09-30
1205242161 Lisa Gray Counselor 2885 W Rick Dr, Port Huron, MI 48060 2014-07-10
1861758880 Aaron Overly Surgery 2609 Electric Ave Ste B&, Port Huron, MI 48060 2012-04-03
1942591508 S Akram Ali Surgery 3270 Waldheim Dr, Port Huron, MI 48060 2011-04-29
1417258179 Nicholas Alexander Tobianski Physician Assistant 3550 Pine Grove Avenue, Port Huron, MI 48060 2010-11-11
1598092769 Blue Water Pharmacy LLC Pharmacy 1524 10th Street, Port Huron, MI 48060 2009-11-10
Find all providers in zip 48060

Taxonomy Information

Taxonomy Code 3336L0003X
Grouping Suppliers
Classification Pharmacy
Specialization Long Term Care Pharmacy

Taxonomy Definition

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]

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1437772159 Krx Medication Consultants Pharmacy 8266 Fernwood St, Augusta, MI 49012 2020-05-28
1235751306 Ypsilanti Family Pharmacy, Inc. Pharmacy 2287 Ellsworth Rd Ste A, Ypsilanti, MI 48197-4805 2020-05-12
1366082935 Home Town Pharmacy Inc Pharmacy 1114 W South Airport Rd, Traverse City, MI 49686-4739 2020-01-13
1619510328 Great Lakes Pharmacies I Inc Pharmacy 6213 Chicago Rd Ste 200, Warren, MI 48092-1697 2019-10-25
1710520143 H & L Drugs Inc Pharmacy 1455 S Lapeer Rd Ste 101, Lake Orion, MI 48360-1468 2019-10-17
1225688229 Guardian Pharmacy of Grand Rapids, LLC Pharmacy 2930 29th St Se, Grand Rapids, MI 49512-1723 2019-09-12
1457905259 Senior Care Rx LLC Pharmacy 24293 Telegraph Rd Ste 130, Southfield, MI 48033-7924 2019-07-30
1063071637 Smart Rx LLC Pharmacy 25464 Van Born Rd, Dearborn Heights, MI 48125 2019-06-07
1457812117 Pharmtek LLC Pharmacy 3307 Orchard Lake Rd, Keego Harbor, MI 48320-1308 2019-03-26
1801350772 Prestige Specialty Pharmacy 2 Pharmacy 31700 Van Dyke Ave Ste B, Warren, MI 48093-7949 2019-01-24
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Competitor

Search similar providers

City PORT HURON
Zip Code 48060

Improve Information

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Dataset Information

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.

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