GENOA HEALTHCARE, LLC (NPI# 1649622283) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649622283 |
| Entity Type | Organization |
| Organization Name | GENOA HEALTHCARE, LLC |
| Practice Address |
824 N 99th Ave Ste 106 Avondale AZ 85323-5327 |
| Mailing Address |
Po Box 77030 Minneapolis MN 55480-7730 |
| Practice Telephone | 6028994911 |
| Practice Fax Number | 4807506864 |
| Mailing Telephone | 2532180830 |
| Mailing Fax Number | 2532174306 |
| Enumeration Date | 2016-07-07 |
| Last Update Date | 2020-03-19 |
| 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 | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
Y006859 | AZ | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2160978 | 01 | |
| AZ | 205305 | 05 |
| 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 |
824 N 99TH AVE STE 106 |
| City | AVONDALE |
| State | AZ |
| Zip Code | 85323-5327 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932663994 | Bridgewater Avondale Operations, LLC | Assisted Living Facility | 295 E Van Buren Street, Avondale, AZ 85323 | 2019-01-24 |
| 1104309152 | Carlos Sifuentes | Physical Therapist | 10750 W Mcdowell Rd., Ste. B-210, Avondale, AZ 85323 | 2018-09-14 |
| 1225534688 | Dayna Sue Kaepp | Registered Nurse | 3300 N. Santa Fe Trail, Avondale, AZ 85323 | 2018-04-04 |
| 1407376700 | Amanda Lynn Radcliffe | Nurse Practitioner | 824 N. 99th Ave Ste 108, Avondale, AZ 85323 | 2017-06-27 |
| 1093253361 | Aquatic-n-writing Rehad | Home Health | 12355 West Cocopah Street, Avondale, AZ 85323 | 2017-02-07 |
| 1750838348 | Annette A Alvarez | Specialist/Technologist | 295 W Western Avenue, Avondale, AZ 85323 | 2016-09-01 |
| 1649726886 | Michelle R Dotson | Contractor | 12115 W Van Buren St Apt 1924, Avondale, AZ 85323 | 2016-08-28 |
| 1619370756 | Amanda Mann | Physical Therapy Assistant | 12804 West Hildalgo, Avondale, AZ 85323 | 2014-10-03 |
| 1326459306 | Ma Caubalejo | Physical Therapist | 350 East La Canada Blvd, Avondale, AZ 85323 | 2014-05-13 |
| 1093139545 | Mark Salvador | Physical Therapy Assistant | 11722 W. Mountain View Dr., Avondale, AZ 85323 | 2014-02-04 |
| Find all providers in zip 85323 | ||||
| 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 |
|---|---|---|---|---|
| 1336749860 | Adepa Pharmacy Pllc | Pharmacy | 8770 N Thornydale Rd, Tucson, AZ 85742-9096 | 2020-10-26 |
| 1801493705 | Cd Pharmacy LLC | Pharmacy | 2710 S Roosevelt St, Tempe, AZ 85282-2089 | 2020-10-04 |
| 1326695545 | Lifecare Pharmacy Yuma LLC | Pharmacy | 2514 South Ave A, Suite 2, Yuma, AZ 85365 | 2019-08-22 |
| 1912366774 | Pharmcare Usa of Greater Phoenix LLC | Pharmacy | 1835 S Alvernon Way Ste 202, Tucson, AZ 85711-5693 | 2016-02-22 |
| 1710388384 | Pharmacy Care Provider LLC | Pharmacy | 1135 N Jefferson Ave, Tucson, AZ 85712-5009 | 2014-09-15 |
| 1912312315 | East Valley Patient Care Services | Pharmacy | 218 W Hampton Ave, #4, Mesa, AZ 85210-5231 | 2014-06-24 |
| 1235565581 | Guardian Pharmacy of Tucson LLC | Pharmacy | 10900 N Stallard Pl, Oro Valley, AZ 85737-9544 | 2013-09-18 |
| 1972944221 | Genoa Healthcare, LLC | Pharmacy | 1500 S White Mountain Rd, Bldg 3, Suite 302, Show Low, AZ 85901-7929 | 2013-07-16 |
| 1730422601 | Genoa Healthcare, LLC | Pharmacy | 10240 N 31st Ave Ste 210, Phoenix, AZ 85051-9565 | 2013-03-29 |
| 1093067670 | Genoa Healthcare, LLC | Pharmacy | 15317 W Bell Rd Ste 106, Suite 106, Surprise, AZ 85374-3901 | 2012-10-08 |
| 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.