GENOA HEALTHCARE LLC NPI 1730124397

NPI Information

NPI: 1730124397
Provider Name: GENOA HEALTHCARE, LLC
Classification: Pharmacy - 3336L0003X
Entity Type: Organization

Specialization: Long Term Care Pharmacy

Address:
379 6TH AVE W
BRADENTON, FL
ZIP 34205
Phone: (941) 748-9409
Get Directions

GENOA HEALTHCARE, LLC is a long term care pharmacy pharmacy in Bradenton, FL. The provider is 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. GENOA HEALTHCARE, LLC NPI is 1730124397. The provider is registered as an organization entity type.

The provider's business location address is:

379 6TH AVE W
BRADENTON, FL
ZIP 34205-820
Phone: (941) 748-9409
Fax: (941) 748-9634

The provider's authorized official is Joseph Douglas .
The authorized official title is Ceo and has the following contact phone number (815) 404-4871.

The enumeration date for this NPI number is 6/18/2006 and was last updated on 10/29/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	332B00000X	Durable Medical Equipment & Medical Supplies		PH21846	FLORIDA	No
2	333600000X	Pharmacy				No
3	3336C0003X	Pharmacy	Community/Retail Pharmacy			No
4	3336L0003X	Pharmacy	Long Term Care Pharmacy	PH21846	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	PH29109	OTHER	FLORIDA	BOP LICENSE
2	031377700	MEDICAID	FLORIDA
3	1017967	OTHER		NCPDP
4	FG5313490	OTHER	FLORIDA	DEA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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