GENOA HEALTHCARE, LLC


Address: 1700 Waterman St, Detroit, MI 48209-2022
Phone: 3138429660

GENOA HEALTHCARE, LLC (NPI# 1811273626) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1811273626
Entity Type Organization
Organization Name GENOA HEALTHCARE, LLC
Practice Address 1700 Waterman St
Detroit
MI 48209-2022
Mailing Address Po Box 77030
Minneapolis
MN 55480-7730
Practice Telephone 3138429660
Practice Fax Number 3138429662
Mailing Telephone 2532180830
Mailing Fax Number 2532174306
Enumeration Date 2011-10-25
Last Update Date 2020-03-24
Authorized Official Name WILLIAM ROBERT GUPTAIL (COO)
Authorized Official Telephone 6516890258
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 3336L0003X Pharmacy
Specialization: Long Term Care Pharmacy
5301009667 MI Suppliers

Other Provider Identifier

State Issuer Identifier Type Code
PK 2132441 01

Other Provider IDs and Locations

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

Other Data Sources

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

Office Location

Street Address 1700 WATERMAN ST
City DETROIT
State MI
Zip Code 48209-2022

Providers in the same location

NPI Name Taxonomy Address Enumeration
1437169786 Jaswant Purohit Psychiatry & Neurology 1700 Waterman St, Detroit, MI 48209-2022 2006-08-09
1912513839 Erica Medina Counselor 1700 Waterman St, Detroit, MI 48209-2022 2020-09-16
1952934366 Laura Owens Registered Nurse 1700 Waterman St, Detroit, MI 48209-2022 2020-02-14
1013556026 Jamice Sade' Harris Social Worker 1700 Waterman St, Detroit, MI 48209-2022 2019-12-23
1033755269 Rodney Harold Averett Counselor 1700 Waterman St, Detroit, MI 48209-2022 2019-11-22
1124685433 Kristina Nicole Henning Social Worker 1700 Waterman St, Detroit, MI 48209-2022 2019-05-22
1861952517 Edward Grumeretz Social Worker 1700 Waterman St, Detroit, MI 48209-2022 2019-03-20
1679047427 Candice Taylor Technician, Other 1700 Waterman St, Detroit, MI 48209-2022 2019-01-15
1154826311 Stephanye Lavenant Case Manager/Care Coordinator 1700 Waterman St, Detroit, MI 48209-2022 2018-03-28
1356846612 Mary Regina Martinez Case Manager/Care Coordinator 1700 Waterman St, Detroit, MI 48209-2022 2018-03-28
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1316501471 El Valle Optical, Inc. Eyewear Supplier (Equipment, not the service) 1940 Campbell, Detroit, MI 48209 2019-04-24
1598211583 Elizabeth Lopez-riachi Technician, Other 1551 Cavaqlry St., Detroit, MI 48209 2016-08-30
1205210333 Yamirka Torres Behavioral Analyst 1551 Cavalry St, Detroit, MI 48209 2015-07-18
1689943359 Jessica Male Pharmacist 6223 W Jefferson Ave, Detroit, MI 48209 2011-12-23
1003070723 Mark Beard General Practice 5700 W Vernor Hwy, Detroit, MI 48209 2008-07-11
1891980330 Emery K Toth Dentist 8028 W Vernor Hwy, Detroit, MI 48209 2007-09-07
1225131881 Eva A Karmo Dentist 4607 W. Vernor Hwy, Detroit, MI 48209 2006-09-07
1023123858 Wanda E Velez Ruiz Internal Medicine 4115 W Vernor, Detroit, MI 48209 2006-08-20
1235142563 Wendy Yousif Mckay Family Medicine 5831 W Vernor, Detroit, MI 48209 2006-08-15
1316950645 Sahir H Cittan Family Medicine 5831 West Vernor, Detroit, MI 48209 2006-08-15
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Taxonomy Information

Taxonomy Code 3336L0003X
Grouping Suppliers
Classification Pharmacy
Specialization Long Term Care Pharmacy

Taxonomy Definition

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]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1699711101 Henry Ford Health System Pharmacy 7800 W Outer Dr Ste 240, Detroit, MI 48235-3458 2006-06-22
1326525965 20201 West Seven Mile Drugs Inc Pharmacy 20201 W 7 Mile Rd, Detroit, MI 48219 2018-07-26
1760765614 Genoa Healthcare, LLC Pharmacy 5716 Michigan Ave, Detroit, MI 48210-3039 2011-09-27
1306151295 Seven Mile Pharmacy LLC Pharmacy 14400 Gratiot Ave, Detroit, MI 48205-2307 2010-08-16

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1437772159 Krx Medication Consultants Pharmacy 8266 Fernwood St, Augusta, MI 49012 2020-05-28
1235751306 Ypsilanti Family Pharmacy, Inc. Pharmacy 2287 Ellsworth Rd Ste A, Ypsilanti, MI 48197-4805 2020-05-12
1366082935 Home Town Pharmacy Inc Pharmacy 1114 W South Airport Rd, Traverse City, MI 49686-4739 2020-01-13
1619510328 Great Lakes Pharmacies I Inc Pharmacy 6213 Chicago Rd Ste 200, Warren, MI 48092-1697 2019-10-25
1710520143 H & L Drugs Inc Pharmacy 1455 S Lapeer Rd Ste 101, Lake Orion, MI 48360-1468 2019-10-17
1225688229 Guardian Pharmacy of Grand Rapids, LLC Pharmacy 2930 29th St Se, Grand Rapids, MI 49512-1723 2019-09-12
1457905259 Senior Care Rx LLC Pharmacy 24293 Telegraph Rd Ste 130, Southfield, MI 48033-7924 2019-07-30
1063071637 Smart Rx LLC Pharmacy 25464 Van Born Rd, Dearborn Heights, MI 48125 2019-06-07
1457812117 Pharmtek LLC Pharmacy 3307 Orchard Lake Rd, Keego Harbor, MI 48320-1308 2019-03-26
1801350772 Prestige Specialty Pharmacy 2 Pharmacy 31700 Van Dyke Ave Ste B, Warren, MI 48093-7949 2019-01-24
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Competitor

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City DETROIT
Zip Code 48209

Improve Information

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Dataset Information

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.

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