# GENOA HEALTHCARE OF RHODE ISLAND I, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Genoa Healthcare
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245405190
- **Authorized official:** RYAN NIEMEYER (CONTROLLER)
- **Authorized official phone:** (253) 218-0830

## Contact information

- **Practice address:** 2756 POST RD, WARWICK, RI 02886-3003
- **Practice address phone:** (401) 921-5660
- **Practice address fax:** (401) 921-6411
- **Mailing address:** PO BOX 77030, MINNEAPOLIS, MN 55480-7730
- **Mailing address phone:** (253) 218-0830
- **Mailing address fax:** (253) 217-4306

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | PHA00440 | RI | — |
| 333600000X | Pharmacy | PHA00440 | RI | — |
| 3336L0003X | Long Term Care Pharmacy | PHA00440 | RI | Yes |

## Other

- **Enumeration date:** 04/22/2008
- **Last updated:** 04/25/2012