GENOA HEALTHCARE, LLC (NPI# 1942755376) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942755376 |
| Entity Type | Organization |
| Organization Name | GENOA HEALTHCARE, LLC |
| Practice Address |
41 Montebello Rd Ste 122 Pueblo CO 81001-1366 |
| Mailing Address |
Po Box 77030 Minneapolis MN 55480-7730 |
| Practice Telephone | 7192831075 |
| Practice Fax Number | 7195434096 |
| Mailing Telephone | 2532180830 |
| Mailing Fax Number | 2532174306 |
| Enumeration Date | 2016-08-15 |
| Last Update Date | 2020-03-17 |
| 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 | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
PDO.1680000119 | CO | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2164329 | 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 |
41 MONTEBELLO RD STE 122 |
| City | PUEBLO |
| State | CO |
| Zip Code | 81001-1366 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316218035 | Gregory Rice | Pharmacist | 41 Montebello Rd Ste 122, Pueblo, CO 81001-1366 | 2012-01-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588222863 | 1111 Bonforte Opco LLC | Respite Care | 855 Hunter Dr., Pueblo, CO 81001 | 2019-06-03 |
| 1992276026 | Andrew Benjamin Basham | Counselor | 1003 Rupple St Pueblo Co 81001, 606, Pueblo, CO 81001 | 2018-12-16 |
| 1316456981 | Amy R Leibli | Nurse Practitioner | 1080 Chinook Lane, Pueblo, CO 81001 | 2017-09-26 |
| 1457781262 | Ron Concialdi | Dentist | 2037 Jerry Murphy Rd., Pueblo, CO 81001 | 2013-11-14 |
| 1609146950 | Natasha Liette Mondragon | Registered Nurse | 1302 E. 5th, Pueblo, CO 81001 | 2012-01-04 |
| 1023303575 | Malinda Lee Davis | Registered Nurse | 1302 E 5th, Pueblo, CO 81001 | 2011-06-13 |
| 1679876429 | Michael Edward Leyba | Substance Abuse Rehabilitation Facility | 4 Montebello Rd., Pueblo, CO 81001 | 2010-12-17 |
| 1609008796 | Laura Ann Mcmahon | Nurse Practitioner | 4020 Jerry Murphy Rd/, Pueblo, CO 81001 | 2009-08-21 |
| 1730380882 | Corrine Stella Tafoya | Counselor | 44 Calhoun Rd, Pueblo, CO 81001 | 2007-05-29 |
| 1518171008 | George Henry Beck | Dentist | 1700 N Salem Ave, Suite A, Pueblo, CO 81001 | 2007-05-10 |
| Find all providers in zip 81001 | ||||
| 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 |
|---|---|---|---|---|
| 1174140750 | Broadway Pharmacy Inc. | Pharmacy | 101 Colorado Ave, Pueblo, CO 81004-4213 | 2020-06-30 |
| 1629231626 | Genoa Healthcare, LLC | Pharmacy | 1304 Chinook Ln, Pueblo, CO 81001-1851 | 2008-07-09 |
| 1457483851 | Colorado Mental Health Institute Pueblo | Pharmacy | 1600 W 24th St, Pueblo, CO 81003-1411 | 2007-03-12 |
| 1235261637 | Colorado Mental Health Institute Pueblo | Pharmacy | 1600 W 24th St, Pueblo, CO 81003-1411 | 2007-03-12 |
| 1518903087 | Omnicare Pharmacy of Pueblo, LLC | Pharmacy | 4602 N Elizabeth St, Suite 190, Pueblo, CO 81008-2072 | 2006-06-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659918894 | Beatties Community Pharmacy LLC | Pharmacy | 3140 Village Vista Dr Unit 100, Erie, CO 80516-2529 | 2019-12-06 |
| 1710477385 | Cd Colorado Pharmacy LLC | Pharmacy | 1240 S Parker Rd Ste 200, Denver, CO 80231-2177 | 2018-05-18 |
| 1275053761 | Mountain Key Rx | Pharmacy | 18172 Teller County Road 1, Florissant, CO 80816 | 2017-06-26 |
| 1053780866 | Vista Care Pharmacy LLC | Pharmacy | 133 Adams St, Monte Vista, CO 81144-1444 | 2015-09-22 |
| 1235516402 | Op Pharmacy LLC | Pharmacy | 6021 S Syracuse Way Ste 117, Greenwood Village, CO 80111-4747 | 2015-04-27 |
| 1326483108 | Trhc Opco, Inc. | Pharmacy | 5303 Spine Rd Ste 100, Boulder, CO 80301-3300 | 2013-05-07 |
| 1548536899 | Pioneer Pharmacy LLC | Pharmacy | 1115 Elkton Dr Ste 203, Colorado Springs, CO 80907-3597 | 2012-03-30 |
| 1447374046 | Kohler Professional Pharmacy LLC | Pharmacy | 1007 Elkton Drive, Colorado Springs, CO 80907-7556 | 2007-03-19 |
| 1467580720 | High Plains Medical LLC | Pharmacy | 314 14th St, Burlington, CO 80807-1608 | 2007-03-01 |
| 1265597447 | Rx Plus Limited Palisade LLC | Pharmacy | 707 Elberta Ave Unit B, Palisade, CO 81526-8806 | 2006-12-27 |
| 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.