NPIMap

Organization Active NPI

Genoa Healthcare of New Jersey, LLC

Doing business as Genoa Healthcare

  • Long Term Care Pharmacy
  • Lawrenceville, NJ
National Provider Identifier
1376953778
Registry record updated May 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
GENOA HEALTHCARE OF NEW JERSEY, LLC
Doing business as
Genoa Healthcare
Practice address
2550 Brunswick Pike
Suite 1a
Lawrenceville, NJ 08648-4103
Phone
(253) 218-0830
Fax
(253) 217-4306
NPI assigned
May 7, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2014

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

Authorized official

Name
Ryan Niemeyer
Title
Controller
Phone
(253) 218-0830

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

2550 Brunswick Pike
Suite 1a
Lawrenceville, NJ 08648-4103

Mailing address

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

Other names 1

  • Genoa Healthcare Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Genoa Healthcare2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2550 Brunswick Pike
Ste 1A
Lawrenceville, NJ 08648

NPI Registry JSON

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

{
    "created_epoch": "1399420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399420800000",
    "number": "1376953778",
    "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": "2550 BRUNSWICK PIKE",
            "address_2": "SUITE 1A",
            "city": "LAWRENCEVILLE",
            "state": "NJ",
            "postal_code": "086484103",
            "telephone_number": "253-218-0830",
            "fax_number": "253-217-4306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENOA HEALTHCARE OF NEW JERSEY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-07",
        "last_updated": "2014-05-07",
        "status": "A",
        "authorized_official_last_name": "NIEMEYER",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "253-218-0830"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Genoa Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lawrenceville, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2014; 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.