Organization Name: | GENOA A QOL HEALTHCARE COMPANY LLC |
NPI Number: | 1558749408 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RYAN NIEMEYER (CONTROLLER) |
Mailing Address: | 2100 Goshen Rd Ste 111 Fort Wayne |
State: | IN US |
Postal Code: | 468081493 |
Phone Number: | 2602030998 |
Fax Number: | 2604827151 |
NPI Enumeration Date: | 05/12/2015 |
NPI Last Update Date: | 12/23/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |