Organization Active NPI

Genoa Healthcare of Ky LLC

  • Long Term Care Pharmacy
  • Owensboro, KY
National Provider Identifier
1649385675
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
GENOA HEALTHCARE OF KY LLC
Practice address
1100 Walnut St
Owensboro, KY 42301-2956
Phone
(270) 689-0002
Fax
(270) 689-0079
NPI assigned
Aug 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Kevin Martyn
Title
President
Phone
(253) 639-5088

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X P07131 KY
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

1100 Walnut St
Owensboro, KY 42301-2956

Mailing address

510 E Main St
Auburn, WA 98002-5502

Other identifiers 1

IdentifierTypeStateIssuer
1829641OtherOTHER ID NUMBER-COMMERCIAL NUMBER

National Provider Directory

National Provider Directory
Tax ID family
Genoa Healthcare of Kentucky LLC2 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.

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1649385675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 E MAIN ST",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980025502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 WALNUT ST",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423012956",
            "telephone_number": "270-689-0002",
            "fax_number": "270-689-0079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENOA HEALTHCARE OF KY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "MARTYN",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "253-639-5088"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "KY",
            "license": "P07131",
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "1829641",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Owensboro, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.