GENOA HEALTHCARE LLC NPI 1962929505

NPI Information

NPI: 1962929505
Provider Name: GENOA HEALTHCARE, LLC

Doing Business As: GENOA HEALTHCARE

Classification: Pharmacy - 3336L0003X
Entity Type: Organization

Specialization: Long Term Care Pharmacy

Address:
1441 W CENTRAL PARK AVE STE 53
DAVENPORT, IA
ZIP 52804
Phone: (563) 265-6955
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GENOA HEALTHCARE, LLC is a long term care pharmacy pharmacy in Davenport, IA. 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 1962929505. The provider is registered as an organization entity type.
The provider Is Doing Business As Genoa Healthcare.

The provider's business location address is:

1441 W CENTRAL PARK AVE STE 53
DAVENPORT, IA
ZIP 52804-707
Phone: (563) 265-6955
Fax: (563) 275-3296

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 8/24/2017 and was last updated on 11/9/2021.

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	333600000X	Pharmacy				No
2	3336C0003X	Pharmacy	Community/Retail Pharmacy			No
3	3336L0003X	Pharmacy	Long Term Care Pharmacy	1630	IOWA	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	0711082	MEDICAID	IOWA
2	2175736	OTHER		PK

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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