NPIMap

Organization Active NPI

Genoa Healthcare, LLC

  • Long Term Care Pharmacy
  • Surprise, AZ
National Provider Identifier
1093067670
Registry record updated Apr 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
Y005742 Issued in AZ
Legal business name
GENOA HEALTHCARE, LLC
Practice address
15317 W Bell Rd Ste 106
Suite 106
Surprise, AZ 85374-3901
Phone
(623) 544-5190
Fax
(623) 214-5234
NPI assigned
Oct 8, 2012
Last updated
Apr 26, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 26, 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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X Y005742 AZ Primary

Addresses

Primary practice location

15317 W Bell Rd Ste 106
Suite 106
Surprise, AZ 85374-3901

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
2137243OtherPK

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 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1349654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619395200000",
    "number": "1093067670",
    "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": "15317 W BELL RD STE 106",
            "address_2": "SUITE 106",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853743901",
            "telephone_number": "623-544-5190",
            "fax_number": "623-214-5234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENOA HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-08",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "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": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "AZ",
            "license": "Y005742",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2137243",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Surprise, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 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.