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).
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 |
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 |
State | Issuer | Identifier | Type Code |
---|---|---|---|
PK | 2167615 | 01 | |
MI | 1497791313 | 05 |
Other Name | Type Code |
---|---|
Genoa-QoL 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 |
Street Address |
3111 ELECTRIC AVE |
City | PORT HURON |
State | MI |
Zip Code | 48060-8127 |
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 |
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 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 |
---|---|---|---|---|
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 |
Find all providers with the same taxonomy |
City | PORT HURON |
Zip Code | 48060 |
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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.