Organization Name: | GENOA, A QOL HEALTHCARE COMPANY, LLC |
NPI Number: | 1912092826 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RYAN NIEMEYER (CONTROLLER) |
Mailing Address: | 404 Spring St Suite 242 Jeffersonville |
State: | IN US |
Postal Code: | 471303452 |
Phone Number: | 8122846418 |
Fax Number: | 8122846419 |
NPI Enumeration Date: | 10/04/2006 |
NPI Last Update Date: | 05/03/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | 60006030A |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IN |
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 |