NPIMap

Organization Active NPI

Genesis Healthcare System

Doing business as Genesis Roseville Pharmacy

  • Community/Retail Pharmacy
  • Roseville, OH
National Provider Identifier
1861449043
Registry record updated Sep 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
02-707700 Issued in OH
Legal business name
GENESIS HEALTHCARE SYSTEM
Doing business as
Genesis Roseville Pharmacy
Practice address
157 S Main St
Roseville, OH 43777-1238
Phone
(740) 697-0348
NPI assigned
May 31, 2006
Last updated
Sep 11, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2023

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

Authorized official

Name
Michael Norman
Title
Cfo
Phone
(740) 454-4773

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Community/Retail Pharmacy 3336C0003X 02-707700 OH Primary

Addresses

Primary practice location

157 S Main St
Roseville, OH 43777-1238

Mailing address

133 N Maysville Ave
Zanesville, OH 43701-6112
Phone (740) 454-5666

Other identifiers 2

IdentifierTypeStateIssuer
0232000344OtherOHSTATE LICENSE
0887901MedicaidOH

Other names 1

  • Genesis Roseville Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20230717001144 OH DME Supplier - PharmacyDME Supplier - Medical Supply Company With Registered Pharmacist 1759279953 Practice locations: Roseville, OH
O20240323000260 OH Part B Supplier - Pharmacy 1759279953 Practice locations: Roseville, OH
O20240511000339 OH Part B Supplier - Pharmacy 1759279953 4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Zanesville, OH; Roseville, OH; New Concord, OH; Somerset, OH

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D2184481Genesis Roseville Pharmacy157 S Main Street, Roseville, OH 43777Certificate of waiverMay 19, 2028

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Genesis Healthcare System157 S Main St, Roseville, OH 43777-1238(740) 697-0348 Epoetin|Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order)|Heat & Cold Applications|Traction Equipment|Canes and/or Crutches|Walkers|Wheelchairs … Accepts assignmentParticipating since Oct 1, 1984

National Provider Directory

National Provider Directory
Tax ID family
Genesis Roseville Pharmacy18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

157 S Main St
Roseville, OH 43777
Phone (740) 697-0348

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Genesis HomecareZanesville, OH, CCN 367114 Home health agency 5% Or Greater Direct Ownership Interest Nov 5, 2010

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694390400000",
    "number": "1861449043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 N MAYSVILLE AVE",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "437016112",
            "telephone_number": "740-454-5666",
            "fax_number": "740-452-7563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "157 S MAIN ST",
            "city": "ROSEVILLE",
            "state": "OH",
            "postal_code": "437771238",
            "telephone_number": "740-697-0348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS HEALTHCARE SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-31",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A",
        "authorized_official_last_name": "NORMAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "740-454-4773"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OH",
            "license": "02-707700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "0232000344",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0887901",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Genesis Roseville Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Genesis Roseville Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Roseville, OH

Sources for this page

Verify at the official NPI Registry.