Organization Name: | GENOA, A QOL HEALTHCARE COMPANY, LLC |
NPI Number: | 1982931788 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RYAN NIEMEYER (CONTROLLER) |
Mailing Address: | 1930 Coon Rapids Blvd Nw Coon Rapids |
State: | MN US |
Postal Code: | 554334708 |
Phone Number: | 6515837093 |
Fax Number: | 6516364073 |
NPI Enumeration Date: | 11/16/2009 |
NPI Last Update Date: | 05/04/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | 263445 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MN |
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 |