Organization Name: | GENOA, A QOL HEALTHCARE COMPANY, LLC |
NPI Number: | 1700174695 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RYAN NIEMEYER (CONTROLLER) |
Mailing Address: | 415 E Madison St Room S-304, Third Floor South Bend |
State: | IN US |
Postal Code: | 466172322 |
Phone Number: | 5742086684 |
Fax Number: | 5743672026 |
NPI Enumeration Date: | 07/13/2011 |
NPI Last Update Date: | 05/03/2016 |
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 |