GENOA HEALTHCARE, LLC (NPI# 1710359864) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710359864 |
| Entity Type | Organization |
| Organization Name | GENOA HEALTHCARE, LLC |
| Practice Address |
600 Coastal Village Dr Rm 107 Brunswick GA 31520-1973 |
| Mailing Address |
Po Box 77030 Minneapolis MN 55480-7730 |
| Practice Telephone | 9125744210 |
| Practice Fax Number | 9122650060 |
| Mailing Telephone | 2532180830 |
| Mailing Fax Number | 2532174306 |
| Enumeration Date | 2015-10-28 |
| Last Update Date | 2020-03-12 |
| 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 | ||
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
PHRE010194 | GA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2155609 | 01 |
| 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 |
600 COASTAL VILLAGE DR RM 107 |
| City | BRUNSWICK |
| State | GA |
| Zip Code | 31520-1973 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588188908 | Wendy Watkins Gerken | Pharmacist | 600 Coastal Village Dr Rm 107, Brunswick, GA 31520-1973 | 2017-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760953434 | David S Deuser Md & Associates PC | Psychiatry & Neurology | 7 Saint Andrews Court, Brunswick, GA 31520 | 2018-12-06 |
| 1063961845 | Irene Limon | Licensed Practical Nurse | 2009 Ellis Street, Brunswick, GA 31520 | 2016-09-22 |
| 1770936551 | Elaine Latimer-tandy | Counselor | 1801 Gloucester St Ste E, Brunswick, GA 31520 | 2016-07-18 |
| 1710336326 | Giva, Inc. | Home Health | 8 St Andrews Court, Brunswick, GA 31520 | 2016-06-06 |
| 1447618525 | Parmelee Eye Care LLC | Point of Service | 1909 Gloucester St, Brunswick, GA 31520 | 2016-02-04 |
| 1578947800 | Holly Diskin Kinsey | Nurse Practitioner | 3400 Parkwood Drive, Brunswick, GA 31520 | 2015-07-16 |
| 1679976419 | Miriam Hosey | Registered Nurse | 2747 Fourth Street, Glynn County Health Dept., Brunswick, GA 31520 | 2014-10-08 |
| 1558779348 | Tracey Renee Price | Internal Medicine | 3025 Shrine Rd Ste 290, Brunswick, GA 31520 | 2014-07-24 |
| 1770901951 | Candace Shepherd | Social Worker | 707 F Street, Brunswick, GA 31520 | 2014-04-03 |
| 1699193599 | Enrique Martinez, M.d., P.C. | Internal Medicine | 3114 A Shrine Road, Brunswick, GA 31520 | 2014-03-29 |
| Find all providers in zip 31520 | ||||
| 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 |
|---|---|---|---|---|
| 1376793026 | Coastal Pharmacare Inc | Pharmacy | 220 Bythe Island Connector, Brunswick, GA 31520 | 2008-09-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942800271 | Macs Ltc Pharmacy Georgia LLC | Pharmacy | 1351 Oakbrook Dr Ste 110, Norcross, GA 30093-2242 | 2020-10-27 |
| 1295347516 | Kayton Pharmacy LLC | Pharmacy | 541 Forest Pkwy Ste 4, Forest Park, GA 30297-2147 | 2020-08-18 |
| 1205479771 | Welltree Pharmacy LLC | Pharmacy | 5009 Roswell Rd Ste 210, Atlanta, GA 30342-2205 | 2019-10-28 |
| 1346882735 | Mortar and Pestle, LLC | Pharmacy | 300 Mooty Bridge Rd, Lagrange, GA 30240-1881 | 2019-10-17 |
| 1134685241 | Mgp Rx, LLC | Pharmacy | 1951 Canton Rd Ste 290, Marietta, GA 30066-6300 | 2019-02-13 |
| 1326553090 | West Georgia Home Medical Equipment Co Inc | Pharmacy | 1861 Roanoke Rd Ste A, Lagrange, GA 30240-3850 | 2017-12-04 |
| 1295278166 | Prestige Pharmacy Snellville LLC | Pharmacy | 1551 Janmar Rd, Suite B, Snellville, GA 30078-5606 | 2016-11-28 |
| 1609327089 | Butler Long Term Care Solutions | Pharmacy | 10 B North Poplar St, Butler, GA 31006 | 2016-10-20 |
| 1285180711 | Vn Pharmacy LLC | Pharmacy | 5000 Buford Hwy, Suite A-106, Atlanta, GA 30341-3500 | 2016-08-25 |
| 1871953406 | South Georgia Pharmacy Services Inc | Pharmacy | 720 W Central Ave Ste 1, Moultrie, GA 31768-3560 | 2016-02-24 |
| 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.