GENOA HEALTHCARE, LLC (NPI# 1912092826) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912092826 |
| Entity Type | Organization |
| Organization Name | GENOA HEALTHCARE, LLC |
| Practice Address |
404 Spring St Ste 242 Jeffersonville IN 47130-3452 |
| Mailing Address |
Po Box 77030 Minneapolis MN 55480-7730 |
| Practice Telephone | 8122846418 |
| Practice Fax Number | 8122846419 |
| Mailing Telephone | 2532180830 |
| Mailing Fax Number | 2532174306 |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2020-06-10 |
| Authorized Official Name | WILLIAM ROBERT GUPTAIL (CHIEF OPERATIONS OFFICER) |
| Authorized Official Telephone | 2532180830 |
| Is Organization Subpart | Y |
| Parent Organization Name | GENOA HEALTHCARE, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | 60006030A | IN | Suppliers |
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
60006030A | IN | Suppliers |
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| N | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
60006030A | IN | Suppliers |
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200827390B | 05 | |
| IN | DEA | FG5335270 | 01 |
| KY | 7100085390 | 05 | |
| IN | BOP LICENSE | 60006474A | 01 |
| NCPDP | 1561150 | 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 |
| Connecticut Business Registrations | GENOA HEALTHCARE, LLC | 18300 Cascade Avenue South, Suite 251, Tukwila, WA 98188 |
| Street Address |
404 SPRING ST STE 242 |
| City | JEFFERSONVILLE |
| State | IN |
| Zip Code | 47130-3452 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972124717 | Jeffersonville Commons Dental | Dentist | 1019 Jeffersonville Commons Drive, Jeffersonville, IN 47130 | 2020-05-04 |
| 1467099978 | Mercury Ambulance Service Inc | Ambulance | 623 Crestview Court, Jeffersonville, IN 47130 | 2019-12-03 |
| 1427514710 | Conn Hearing Aid Center LLC | Hearing Instrument Specialist | 1516 Spring Street, Jeffersonville, IN 47130 | 2019-02-12 |
| 1619446127 | Wellness for Life | Clinic/Center | 1 Pirate Pl, Charlestown, IN 47130 | 2018-11-14 |
| 1083199939 | Stephanie Allen LLC | Dentist | 434 Patrol Road, Suite 200, Jeffersonville, IN 47130 | 2018-09-26 |
| 1679068332 | Personal Choice Inc | Day Training, Developmentally Disabled Services | 3114 Clear Stream Wat, Jeffersonville, IN 47130 | 2018-06-26 |
| 1417454638 | Jason Allen | Social Worker | 101 Noahs Ln, Jeffersonville, IN 47130 | 2018-04-13 |
| 1508374299 | Kelsey Petty | Social Worker | 101 Noahs Lane, Jeffersonville, IN 47130 | 2018-01-16 |
| 1336658095 | Jenkins Podiatry PC | Podiatrist | 3310 Highway 62 East, Suite 179, Jeffersonville, IN 47130 | 2017-09-26 |
| 1831618602 | Alyssa Marie Elliott | Physical Therapist | 3040 Gottbrath Pkwy, Jeffersonville, IN 47130 | 2017-09-13 |
| Find all providers in zip 47130 | ||||
| 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 |
|---|---|---|---|---|
| 1962870295 | Pca Corrections LLC | Pharmacy | 1740 Williamsburg Dr Ste A, Jeffersonville, IN 47130-8066 | 2015-09-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003437609 | Damasius Inc | Pharmacy | 6949 Kennedy Ave Ste C, Hammond, IN 46323-2245 | 2020-05-05 |
| 1568099703 | In Touch of Indy, LLC | Pharmacy | 851 Columbia Rd Ste 190, Plainfield, IN 46168-7587 | 2020-03-26 |
| 1669030102 | Meds To You LLC | Pharmacy | 8250 Bash St Ste A3, Indianapolis, IN 46250-1938 | 2019-05-30 |
| 1083188973 | Circle City Pharmacy, LLC | Pharmacy | 65 E Garner Rd Ste 200, Brownsburg, IN 46112-7867 | 2019-01-14 |
| 1174091557 | Rubicon Dtp, LLC | Pharmacy | 5751 W 73rd St # A, Indianapolis, IN 46278-1741 | 2018-11-05 |
| 1407235013 | Cppltc LLC | Pharmacy | 482 W Navajo St Ste B, West Lafayette, IN 47906-1940 | 2015-05-28 |
| 1871986596 | N&m Investments | Pharmacy | 30 S Water St Ste B, Franklin, IN 46131-2316 | 2015-03-05 |
| 1588911895 | United Rx, LLC | Pharmacy | 2325 Pointe Pkwy, Carmel, IN 46032-3294 | 2012-08-07 |
| 1265674097 | Pauls Pharmacy Inc | Pharmacy | 4111 N Saint Joseph Ave, Evansville, IN 47720-1206 | 2009-03-25 |
| 1235388356 | Prairestone Pharmacy LLC | Pharmacy | 9320 Priority Way West Dr, Indianapolis, IN 46240-1468 | 2008-09-12 |
| Find all providers with the same taxonomy | ||||
| City | JEFFERSONVILLE |
| Zip Code | 47130 |
Please comment or provide details below to improve the information on GENOA HEALTHCARE, LLC.
| 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.