Active NPI
Genesis Pharmacy Corp
Doing business as The Medicine Shoppe
- Long Term Care Pharmacy
- Lake Elsinore, CA
National Provider Identifier
1790603512
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Long Term Care Pharmacy
- Legal business name
- GENESIS PHARMACY CORP
- Doing business as
- The Medicine Shoppe
- Practice address
- 31946 Mission TRL Ste A1
Lake Elsinore, CA 92530-4539 - Phone
- (951) 245-1373
- Fax
- (877) 489-1666
- NPI assigned
- Jul 8, 2026
- Last updated
- Sep 24, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Fady Mosaad, RPH
- Title
- Ceo
- Phone
- (951) 245-1373
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Long Term Care Pharmacy | 3336L0003X | Primary |
Addresses
Primary practice location
31946 Mission TRL Ste A1
Lake Elsinore, CA 92530-4539
Mailing address
31946 Mission TRL Ste A1
Lake Elsinore, CA 92530-4539
Phone (951) 245-1373
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PHY57029 | Other | CA | PHARMACY PERMIT |
Other names 1
- The Medicine Shoppe
National Provider Directory
National Provider Directory- Tax ID family
- Enova Care Pharmacy
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Enova Care Pharmacy
- Community/Retail Pharmacy
- Lake Elsinore, CA
- NPI 1982169561
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1783468800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1790208000000",
"number": "1790603512",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "31946 MISSION TRL STE A1",
"city": "LAKE ELSINORE",
"state": "CA",
"postal_code": "925304539",
"telephone_number": "951-245-1373",
"fax_number": "877-489-1666"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "31946 MISSION TRL STE A1",
"city": "LAKE ELSINORE",
"state": "CA",
"postal_code": "925304539",
"telephone_number": "951-245-1373",
"fax_number": "877-489-1666"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GENESIS PHARMACY CORP",
"organizational_subpart": "NO",
"enumeration_date": "2026-07-08",
"last_updated": "2026-09-24",
"certification_date": "2026-09-24",
"status": "A",
"authorized_official_last_name": "MOSAAD",
"authorized_official_first_name": "FADY",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "951-245-1373",
"authorized_official_credential": "RPH"
},
"taxonomies": [
{
"code": "3336L0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Long Term Care Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACY PERMIT",
"identifier": "PHY57029",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "The Medicine Shoppe",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Lake Elsinore, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.