GENOA HEALTHCARE, LLC (NPI# 1790202323) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790202323 |
| Entity Type | Organization |
| Organization Name | GENOA HEALTHCARE, LLC |
| Other Organization Name | GENOA HEALTHCARE |
| Practice Address |
702 Sunset Dr Ste P1 Ontario OR 97914-3121 |
| Mailing Address |
Po Box 77030 Minneapolis MN 55480-7730 |
| Practice Telephone | 5412166388 |
| Practice Fax Number | 5413592465 |
| Mailing Telephone | 2532180830 |
| Mailing Fax Number | 2532174306 |
| Enumeration Date | 2017-08-24 |
| 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 |
IP-0002271-CS | OR | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 2097078 | 05 | |
| OR | 500736927 | 05 | |
| PK | 2173722 | 01 |
| 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 |
| Street Address |
702 SUNSET DR STE P1 |
| City | ONTARIO |
| State | OR |
| Zip Code | 97914-3121 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467925420 | The Family Place D/b/a Tfp Services Therapeutic | Case Manager/Care Coordinator | 390 Ne 2nd St., Ontario, OR 97914 | 2019-01-02 |
| 1154805729 | Ronald William Strohmeyer | Physician Assistant | 2327 S.w. 4th Ave, Ontario, OR 97914 | 2018-09-19 |
| 1700334117 | Arlene Schwenke | Social Worker | 686 Nw 9th St., Ontario, OR 97914 | 2016-09-14 |
| 1871990408 | Sally Melissa Sluder | Nurse Practitioner | 351 Sw 9th Ave, Ontario, OR 97914 | 2014-11-25 |
| 1932460870 | E Patricia Jeanne Engel | Surgery | 1050 Sw 3rd Ave Ste 2600, Ontario, OR 97914 | 2012-06-07 |
| 1487946521 | Tyler Jepson | Physical Therapist | 1182 Sw 4th Avenue, Ontario, OR 97914 | 2011-05-09 |
| 1255641577 | Cami Lyn Rebmann | Pharmacist | 728 S 4th Ave, Ontario, OR 97914 | 2010-10-20 |
| 1295051126 | Project Dove | Case Manager/Care Coordinator | 915-02 Sw 2nd Ave, Ontario, OR 97914 | 2010-04-16 |
| 1467666024 | Tfp Therapeutic Service, Inc. | Counselor | 390 Ne 2nd Street, Ontario, OR 97914 | 2007-05-10 |
| 1639381569 | Emeritus Corporation | Assisted Living Facility | 1372 Southwest 8th Avenue, Ontario, OR 97914 | 2007-05-04 |
| Find all providers in zip 97914 | ||||
| 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 |
|---|---|---|---|---|
| 1598909020 | Rx Two Pharmacy Services Inc | Pharmacy | 350 S Milliken Ave, Ste B, Ontario, CA 91761-7844 | 2009-04-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023440864 | Olson Pharmacy Services | Pharmacy | 617 Monroe St, Oregon City, OR 97045-2336 | 2013-08-03 |
| 1861773798 | Grants Pass Pharmacy, Inc. | Pharmacy | 414 Sw 6th St., Grants Pass, OR 97526-2810 | 2011-09-06 |
| 1003051558 | Howard's Pharmacy Inc. | Pharmacy | 101 N F St, Lakeview, OR 97630-1529 | 2008-12-12 |
| 1558448225 | Pill Box Drugs Inc | Pharmacy | 635 N Arrowleaf Trl, Sisters, OR 97759 | 2006-11-01 |
| 1881776722 | Quisenberry Pharmacies Inc. | Pharmacy | 150 Liberty St Se, Salem, OR 97301-3506 | 2006-10-19 |
| 1093808198 | Pill Box Drugs Inc | Pharmacy | 906 Nw Kings Blvd, Corvallis, OR 97330 | 2006-10-02 |
| 1871690719 | Pill Box Drugs Inc | Pharmacy | 910 Nw Kings Blvd, Corvallis, OR 97330-2505 | 2006-09-20 |
| 1952405664 | Dept. of Human Srvcs/office of Fin. Srvcs Dba Irs/eopc/eotc/osh/osh-p | Pharmacy | 2600 Westgate, Pendleton, OR 97801-9604 | 2006-09-12 |
| 1780795765 | Evergreen Pharmaceutical, LLC | Pharmacy | 259 E Barnett Rd Ste L, Medford, OR 97501-7953 | 2006-08-31 |
| 1235240391 | Evergreen Pharmaceutical, LLC | Pharmacy | 11933 Ne Glenn Widing Dr, Portland, OR 97220-9099 | 2006-08-31 |
| 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.