GENOA HEALTHCARE, LLC (NPI# 1851496160) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1851496160 |
Entity Type | Organization |
Organization Name | GENOA HEALTHCARE, LLC |
Practice Address |
526 W State St Rockford IL 61101-1214 |
Mailing Address |
Po Box 77030 Minneapolis MN 55480-7730 |
Practice Telephone | 8159628192 |
Practice Fax Number | 8159625703 |
Mailing Telephone | 2532180830 |
Mailing Fax Number | 2532174306 |
Enumeration Date | 2006-09-13 |
Last Update Date | 2020-03-24 |
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 | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
N | 333600000X | Pharmacy | Suppliers | ||
Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
58013565 | IL | Suppliers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NCPDP PROVIDER IDENTIFICATION NUMBER | 1480057 | 01 | |
IL | 743152173002 | 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 |
526 W STATE ST |
City | ROCKFORD |
State | IL |
Zip Code | 61101-1214 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1558327544 | Janet Wattles Center | Clinic/Center | 526 W State St, Rockford, IL 61101-1214 | 2006-04-26 |
1992362685 | Swedishamerican Hospital | Family Medicine | 526 W State St, Rockford, IL 61101-1214 | 2019-05-29 |
1659793149 | Melissa Crowell | Social Worker | 526 W State St, Rockford, IL 61101-1214 | 2014-01-17 |
1699106468 | Rosecrance Inc | Clinic/Center | 526 W State St, Rockford, IL 61101-1214 | 2013-12-04 |
1518307131 | Leah Carol Spindler | Counselor | 526 W State St, Rockford, IL 61101-1214 | 2013-06-27 |
1104269695 | Brenda Hunt | Registered Nurse | 526 W State St, Rockford, IL 61101-1214 | 2013-04-15 |
1659612083 | James R. Wu | Licensed Practical Nurse | 526 W State St, Rockford, IL 61101-1214 | 2013-03-11 |
1689912099 | Kimberly C Holum | Social Worker | 526 W State St, Rockford, IL 61101-1214 | 2013-01-18 |
1518203074 | Kala Anders | Counselor | 526 W State St, Rockford, IL 61101-1214 | 2013-01-02 |
1508102062 | Deborah Finke | Counselor | 526 W State St, Rockford, IL 61101-1214 | 2013-01-02 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417338799 | Latavia Shantaye Agada | Social Worker | 2823 Glenwood Ave., Rockford, IL 61101 | 2015-06-12 |
1013397561 | Charlene Donahoe | Student in an Organized Health Care Education/Training Program | 235 Wyman St, Rockford, IL 61101 | 2015-05-30 |
1205238623 | Crusaders Central Clinic Association | Clinic/Center | 1002 N Pierpont Ave, Rockford, IL 61101 | 2014-09-17 |
1780717454 | Hearing Pros Inc | Audiologist | 3902 West Riverside Blvd, In Wal Mart, Rockford, IL 61101 | 2007-03-13 |
1821156951 | Neurological Clinic of Rockford Sc | Neurological Surgery | 2825 Glenwood Avenue, Rockford, IL 61101 | 2006-12-04 |
1265470496 | Daniel Sommer | Social Worker | 2823 Glenwood Avenue, Rockford, IL 61101 | 2006-06-02 |
1508093253 | Patricia Kroll | Social Worker | 526 W State Street, Rockford, IL 61101 | 2009-06-19 |
1346462330 | Carol J O'haron | Social Worker | 526 W State Street, Rockford, IL 61101 | 2007-05-02 |
1356563332 | Lynn E Cadmus | Social Worker | 526 W State Street, Rockford, IL 61101 | 2007-05-02 |
1083836928 | Carol L Craig | Psychiatry & Neurology | 526 W State Street, Rockford, IL 61101 | 2007-05-02 |
Find all providers in zip 61101 |
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 |
---|---|---|---|---|
1174865133 | Genoa Healthcare, LLC | Pharmacy | 2704 N Main St Rm A104, Rockford, IL 61103-3112 | 2013-03-18 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1912512989 | Millenium Pharmacy Ltd | Pharmacy | 10604 Southwest Hwy Ste 102, Chicago Ridge, IL 60415-2704 | 2020-09-15 |
1992265235 | Illini Clinic Pharmacy Inc | Pharmacy | 211 S 1st Street, Alpha, IL 61413 | 2019-03-22 |
1750841342 | Illini Clinic Pharmacy Inc | Pharmacy | 855 Illini Dr Ste 200, Silvis, IL 61282-2904 | 2019-03-21 |
1679039358 | Remedi Seniorcare of Chicago, LLC | Pharmacy | 3600 Lacey Road, Suite 500, Downers Grove, IL 60515 | 2019-02-18 |
1720574676 | Critical Care Rx, LLC | Pharmacy | 126 Oak St, Peoria, IL 61602 | 2018-07-03 |
1538672449 | Wear Ltc | Pharmacy | 527 N Madison St Ste B, Carthage, IL 62321-1034 | 2017-11-14 |
1124546031 | Symbria Rx Services, LLC. | Pharmacy | 3200 Grant St Rm 41, Evanston, IL 60201-1903 | 2017-08-31 |
1699146720 | Pharmblue Illinois LLC | Pharmacy | 2960 Chartres St Ste 100, La Salle, IL 61301-1097 | 2015-10-15 |
1194144691 | Lifemed Illinois, LLC | Pharmacy | 881 Il Route 83, Bensenville, IL 60106-1219 | 2014-04-11 |
1205250412 | Becks Long Term Care Pharmacy Inc | Pharmacy | 1413 Locust Street, Eldorado, IL 62930 | 2014-02-07 |
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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.