NPIMap

Organization Active NPI

Genoa Healthcare, LLC

  • Long Term Care Pharmacy
  • Lebanon, OH
National Provider Identifier
1073929220
Registry record updated Apr 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
CLPH.0224343600 Issued in OH
Legal business name
GENOA HEALTHCARE, LLC
Practice address
975B Kingsview Dr
Lebanon, OH 45036-9562
Phone
(412) 931-3131
Fax
(412) 223-5384
NPI assigned
Jul 9, 2014
Last updated
Apr 21, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Natasha Hennessy
Title
Chief Pharmacy Officer
Phone
(612) 722-4249

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X
Long Term Care Pharmacy 3336L0003X CLPH.0224343600 OH Primary

Addresses

Primary practice location

975B Kingsview Dr
Lebanon, OH 45036-9562

Mailing address

PO Box 77030
Minneapolis, MN 55480-7730
Phone (253) 218-0830

Other identifiers 1

IdentifierTypeStateIssuer
2146668OtherPK

National Provider Directory

National Provider Directory
Tax ID family
Genoa Healthcare LLC760 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 14

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 14

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1404864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618963200000",
    "number": "1073929220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 77030",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554807730",
            "telephone_number": "253-218-0830",
            "fax_number": "253-217-4306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975B KINGSVIEW DR",
            "city": "LEBANON",
            "state": "OH",
            "postal_code": "450369562",
            "telephone_number": "412-931-3131",
            "fax_number": "412-223-5384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENOA HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-09",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A",
        "authorized_official_last_name": "HENNESSY",
        "authorized_official_first_name": "NATASHA",
        "authorized_official_title_or_position": "CHIEF PHARMACY OFFICER",
        "authorized_official_telephone_number": "612-722-4249"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "OH",
            "license": "CLPH.0224343600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2146668",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.