GENOA HEALTHCARE, LLC (NPI# 1669835476) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669835476 |
| Entity Type | Organization |
| Organization Name | GENOA HEALTHCARE, LLC |
| Practice Address |
1212 E College Dr Ste 1 Marshall MN 56258-2010 |
| Mailing Address |
Po Box 77030 Minneapolis MN 55480-7730 |
| Practice Telephone | 5074012004 |
| Practice Fax Number | 5074012006 |
| Mailing Telephone | 2532180830 |
| Mailing Fax Number | 2532174306 |
| Enumeration Date | 2016-03-30 |
| Last Update Date | 2020-03-20 |
| 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 |
|---|---|---|---|---|---|
| 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 |
265274 | MN | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2160315 | 01 | |
| MN | 1669835476 | 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 |
1212 E COLLEGE DR STE 1 |
| City | MARSHALL |
| State | MN |
| Zip Code | 56258-2010 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982196663 | Lachelle Kay Wegener | Pharmacist | 1212 E College Dr Ste 1, Marshall, MN 56258-2010 | 2018-05-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285140012 | Action Manufacturing Inc | Durable Medical Equipment & Medical Supplies | 1105 Lake Road, Marshall, MN 56258 | 2017-12-15 |
| 1124579123 | Themarshrx | Durable Medical Equipment & Medical Supplies | 600 Sherman Ave, Marshall, MN 56258 | 2016-10-14 |
| 1780020370 | Heritage Pointe Senio | Assisted Living Facility | 207 N 4th Street, Marshall, MI 56258 | 2013-05-22 |
| 1528351178 | Lori Anne Lynner | Family Medicine | 3160 Us Hwy 59, Marshall, MN 56258 | 2011-05-16 |
| 1912148545 | Tami J Behnke | Counselor | 1418 State Street, Campus Religious Center, Marshall, MN 56258 | 2009-03-11 |
| 1073768396 | Sharyce Marie Audiology Inc | Audiologist | 1424 East College Drive, Suite 200, Marshall, MN 56258 | 2008-12-01 |
| 1497976625 | Erica Anne Jost | Specialist/Technologist | 1501 State Street, Marshall, MN 56258 | 2007-05-02 |
| 1265597470 | Nancy Louise Hemmingson | Optometrist | 300 S Bruce Street, Avera Marshall Southwest Ophthalmology, Marshall, MN 56258 | 2006-12-27 |
| 1407928187 | Midwest Vision Centers Inc | Technician/Technologist | 1113 E College Drive, Marshall, MN 56258 | 2006-11-15 |
| 1306918354 | Paul Joseph Puetz | Chiropractor | 111 Jewett St, Marshall, MN 56258 | 2006-11-14 |
| Find all providers in zip 56258 | ||||
| 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 |
|---|---|---|---|---|
| 1992848493 | Marshall Medic Pharmacy, Inc. | Pharmacy | 243 Hwy 65 North, Marshall, AR 72650 | 2007-02-14 |
| 1073136529 | Summers Pharmacy of Marshall, LLC | Pharmacy | 895 W College St, Marshall, MO 65340-2912 | 2020-05-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114544822 | Rolseth Drug Co | Pharmacy | 26709 Forest Blvd, Wyoming, MN 55092-8022 | 2020-06-29 |
| 1962037242 | United Community Pharmacy Corporation | Pharmacy | 2500 Highway 88 Ste 105, St Anthony, MN 55418-4138 | 2020-03-07 |
| 1629613005 | Lotus Ltc Pharmacy, LLC | Pharmacy | 9850 51st Ave N Ste 102, Plymouth, MN 55442-3271 | 2019-11-09 |
| 1720541337 | Ltc Prescription Providers #2 | Pharmacy | 220 1/2 Third Avenue, Proctor, MN 55810 | 2019-04-10 |
| 1639634710 | Lewis Family Drug, LLC | Pharmacy | 1105 13th Ave S, Saint James, MN 56081 | 2019-02-04 |
| 1033680046 | Brainerd Medical Center Inc | Pharmacy | 280 Barclay Ave W, Ste 1100, Pine River, MN 56474 | 2018-12-17 |
| 1457832909 | Black Forest Pharmacy Services Ltd | Pharmacy | 108 S 6th St Ste 1, Brainerd, MN 56401-3594 | 2018-08-23 |
| 1467932905 | Watertown Pharmacy LLC | Pharmacy | 204 Lewis Ave S Ste 101, Watertown, MN 55388-4501 | 2018-08-15 |
| 1942702394 | Polaris Pharmacy Services of Minnesota, LLC | Pharmacy | 4220 Park Glen Road, St. Louis Park, MN 55416 | 2018-03-01 |
| 1346757457 | Twin Valley Pharmacy LLC | Pharmacy | 108 Viking Ave W., Ulen, MN 56585 | 2018-01-10 |
| 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.