GENOA HEALTHCARE, LLC (NPI# 1598278806) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598278806 |
| Entity Type | Organization |
| Organization Name | GENOA HEALTHCARE, LLC |
| Other Organization Name | GENOA HEALTHCARE |
| Practice Address |
21 Bridgeway Rd Ste P North Little Rock AR 72113-9514 |
| Mailing Address |
Po Box 77030 Minneapolis MN 55480-7730 |
| Practice Telephone | 5019164073 |
| Practice Fax Number | 5012467658 |
| Mailing Telephone | 2532180830 |
| Mailing Fax Number | 2532174306 |
| Enumeration Date | 2017-11-08 |
| Last Update Date | 2020-03-13 |
| 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 |
AR20872 | AR | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2175872 | 01 | |
| AR | 225333407 | 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 |
| Street Address |
21 BRIDGEWAY RD STE P |
| City | NORTH LITTLE ROCK |
| State | AR |
| Zip Code | 72113-9514 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518467364 | Tara Groff | Pharmacist | 21 Bridgeway Rd Ste P, North Little Rock, AR 72113-9514 | 2018-02-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104347814 | Shasta Dockery | Registered Nurse | 15020 Wade Blvd., North Little Rock, AR 72113 | 2017-07-03 |
| 1235669839 | Robert Mitchell Fisher | Specialist/Technologist | 134 Vienne Pl, Maumelle, AR 72113 | 2017-06-15 |
| 1932516887 | Healthcare Express, LLP | Clinic/Center | 11819 Maumelle Blvd., North Little Rock, AR 72113 | 2014-07-11 |
| 1184997991 | Preston Lewis | Speech-Language Pathologist | 14 Braeswood Place, Maumelle, AR 72113 | 2012-02-10 |
| 1740437813 | Jennifer L Franklin | Social Worker | 115 Audubon Dr Ste 9a, Maumelle, AR 72113 | 2008-08-20 |
| 1861655912 | Dawn Melton Mulkern | Dietitian, Registered | 12 Ninth Fairway Loop, Maumelle, AR 72113 | 2008-07-09 |
| 1902028723 | Robin Reynolds | Dietitian, Registered | 9300 White Oak Crossing, N Little Rock, AR 72113 | 2007-05-02 |
| 1316096498 | Caretech Medical, Inc. | Durable Medical Equipment & Medical Supplies | 8010 Counts Massie Rd, Suite B, North Little Rock, AR 72113 | 2007-01-09 |
| 1548318470 | Supermarket Investors Inc | Pharmacy | 1117 Audubon Dr, Maumelle, AR 72113 | 2007-01-08 |
| 1821177353 | Maumelle Investments & Associates, LLC | Skilled Nursing Facility | 103 Alexandria Drive, Maumelle, AR 72113 | 2006-11-03 |
| Find all providers in zip 72113 | ||||
| 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 |
|---|---|---|---|---|
| 1558475269 | Cp Acquisition LLC | Pharmacy | 7301 Industry Dr, North Little Rock, AR 72117-5314 | 2006-08-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841841715 | Village Apothecary Inc | Pharmacy | 24615 Highway 5, Lonsdale, AR 72087-8017 | 2019-09-23 |
| 1104484971 | Austin Gilbreath | Pharmacy | 970d Ash Flat Dr, Ash Flat, AR 72513-9533 | 2019-06-05 |
| 1295291441 | Health Depot Pharmacies, LLC | Pharmacy | 1610 Fort St, Barling, AR 72923-2018 | 2019-02-13 |
| 1417458829 | Paragon Pharmacy, LLC | Pharmacy | 14524 Cantrell Rd Ste 100a, Little Rock, AR 72223-4700 | 2018-02-22 |
| 1619326881 | Wagner Drugs, Inc. | Pharmacy | 744 Hwy 270 East, Mount Ida, AR 71957 | 2016-06-08 |
| 1669826954 | Caeb Investments Inc. | Pharmacy | 11200 Arch Street, Little Rock, AR 72206 | 2016-04-22 |
| 1215349667 | Midsouth Medical Specialties, LLC | Pharmacy | 5500 Central Avenue, Hot Springs, AR 71913 | 2014-05-20 |
| 1942645569 | Warmack Pharmacies,inc. | Pharmacy | 300 Pine Street, Rison, AR 71665 | 2013-05-09 |
| 1588972418 | Allied Health Services LLC | Pharmacy | 600 N Main St Ste C, Melbourne, AR 72556-0769 | 2010-09-14 |
| 1457565400 | Professional Pharmacy | Pharmacy | 1515 N. Medical Drive, Stuttgart, AR 72160 | 2007-05-09 |
| Find all providers with the same taxonomy | ||||
| City | NORTH LITTLE ROCK |
| Zip Code | 72113 |
Please comment or provide details below to improve the information on GENOA HEALTHCARE, LLC.
| 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.