NPIMap

Organization Active NPI

Genoa Healthcare, LLC

  • Long Term Care Pharmacy
  • Las Vegas, NV
National Provider Identifier
1669040283
Registry record updated Jun 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
GENOA HEALTHCARE, LLC
Practice address
701 Shadow LN Ste 110
Las Vegas, NV 89106-4132
Phone
(253) 218-0830
NPI assigned
Jun 11, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Joseph Douglas
Title
Ceo
Phone
(815) 404-4871

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

701 Shadow LN Ste 110
Las Vegas, NV 89106-4132

Mailing address

707 S Grady Way Ste 700
Renton, WA 98057-3243
Phone (253) 218-0830

National Provider Directory

National Provider Directory
Tax ID family
Genoa Healthcare LLC759 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 4

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1623369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656374400000",
    "number": "1669040283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 S GRADY WAY STE 700",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980573243",
            "telephone_number": "253-218-0830",
            "fax_number": "253-217-4306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 SHADOW LN STE 110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064132",
            "telephone_number": "253-218-0830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENOA HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-11",
        "last_updated": "2022-06-28",
        "certification_date": "2022-06-28",
        "status": "A",
        "authorized_official_last_name": "DOUGLAS",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "815-404-4871"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.