Genahealth Pharmacy Inc

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

Legal business name

GENAHEALTH PHARMACY INC

Practice address

18107 Sherman Way Ste 202
Reseda, CA 91335-8802

Phone

(818) 798-3314

Fax

(818) 614-9074

NPI assigned

Oct 18, 2022

Organization subpart

No

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

Authorized official

Name

Amanda Rose Kiselyuk, PHARM D

Title

President/Ceo

Phone

(818) 798-3314

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• GENAHEALTH PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Amanda Beker

  • Pharmacist
  • North Hollywood, CA
  • NPI 1164060414
  NPD
• Ma Karlynne Lopez Saballa, R.P.T.

  • Physical Therapist
  • Sunland, CA
  • NPI 1598956237
  NPD (past)

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

{
    "created_epoch": "1666051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666051200000",
    "number": "1700502986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18107 SHERMAN WAY STE 202",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913358802",
            "telephone_number": "818-798-3314",
            "fax_number": "818-614-9074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18107 SHERMAN WAY STE 202",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913358802",
            "telephone_number": "818-798-3314",
            "fax_number": "818-614-9074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENAHEALTH PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-18",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A",
        "authorized_official_last_name": "KISELYUK",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "ROSE",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "818-798-3314",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "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": "BOARD OF PHARMACY",
            "identifier": "PHY58685",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GENAHEALTH PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Daniel Lee Garrett Jr.
• Narek Garukyan, DPM
• Ben Gavan
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• Generation Home Health Care
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• Trevor Gentry, RADT
• Afsoon S Gerayli, D.D.S.

• Long Term Care Pharmacy in Reseda, CA
• Providers in Reseda, CA by specialty
• Long Term Care Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.