Organization
GENOA HEALTHCARE OF RHODE ISLAND I, LLC
Active
Other names
Genoa Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN NIEMEYER (CONTROLLER)
(253) 218-0830
Entity
Organization
Contact information
Practice address
2756 POST RD, WARWICK, RI 02886-3003
(401) 921-5660
(401) 921-6411
Mailing address
PO BOX 77030, MINNEAPOLIS, MN 55480-7730
(253) 218-0830
(253) 217-4306
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
PHA00440
RI
333600000X
Pharmacy
PHA00440
RI
3336L0003X
Long Term Care Pharmacy
Primary
PHA00440
RI
Other
Enumeration date
04/22/2008
Last updated
04/25/2012
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