Genoa Healthcare LLC
Organization Active NPI Long Term Care Pharmacy · Hope Valley, RI
NPI 1972270205 · NPPES record last updated Jan 19, 2024
Key facts
- NPI
- 1972270205
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Long Term Care Pharmacy 3336L0003X
- Legal business name
- GENOA HEALTHCARE LLC
- Practice address
- 823 Main St RM B13
Hope Valley, RI 02832-1920 - Phone
- (401) 491-4032
- Fax
- (401) 369-9003
- NPI assigned
- Aug 25, 2021
- Organization subpart
- No
Authorized official
- Name
- Karen Bohmer
- Title
- Secretary
- Phone
- (224) 231-1833
Other NPIs on the same Medicare enrollment 6
Member of 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in RI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20201020001743 | RI | Part B Supplier - Pharmacy | 6608003652 |
7 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Woonsocket, RI; Warwick, RI; Riverside, RI; Newport, RI; Providence, RI; Barrington, RI; Hope Valley, RI |
| O20230419002802 | RI | DME Supplier - Pharmacy | 6608003652 | Practice locations: Hope Valley, RI |
National Provider Directory
Locations
823 Main St
Rm B13
Hope Valley, RI 02832
Phone (401) 491-4032
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | |||
| Long Term Care Pharmacy | 3336L0003X | Yes |
Addresses
Primary practice location
823 Main St RM B13
Hope Valley, RI 02832-1920
Mailing address
707 S Grady Way Ste 400
Renton, WA 98057-3246
Phone (253) 218-0830
Other providers in Hope Valley, RI
- Shital S Desai
- Melanie Kay Dufour-Pilny
- Calli Duthrie
- Mary Frances Dzurinko
- Nickolas Desousa Fitzgerald
- Helen Eileen Gettman
- Ramona Giorgio
- Gordon Orthodontics, Inc.
- Cydney Gregory
- Sean Jason Heller
All providers in Hope Valley, RI · Long Term Care Pharmacy in Rhode Island
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 19, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.