NPIMap

Organization Active NPI

Genoa Community Pharmacy

Doing business as Geneoa Community Pharmacy

  • Community/Retail Pharmacy
  • Genoa, NE
National Provider Identifier
1902045479
Registry record updated Sep 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
2928 Issued in NE
Legal business name
GENOA COMMUNITY PHARMACY
Doing business as
Geneoa Community Pharmacy
Practice address
508 Willard Ave
Genoa, NE 68640-3039
Phone
(402) 993-2400
Fax
(402) 993-2421
NPI assigned
Feb 6, 2009
Last updated
Sep 22, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2014

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

Authorized official

Name
Robert BaileyNPI 1033627302
Title
Pharmacist/Owner
Phone
(402) 366-1417

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 2928 NE Primary
Long Term Care Pharmacy 3336L0003X NU

Addresses

Primary practice location

508 Willard Ave
Genoa, NE 68640-3039

Mailing address

PO Box 10
Genoa, NE 68640-0010
Phone (402) 993-2400

Other identifiers 2

IdentifierTypeStateIssuer
2118928OtherPK
10025721600MedicaidNE

Other names 1

  • Geneoa Community Pharmacy Doing business as

National Provider Directory

National Provider Directory

Member of 1

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

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1233878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411344000000",
    "number": "1902045479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10",
            "city": "GENOA",
            "state": "NE",
            "postal_code": "686400010",
            "telephone_number": "402-993-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 WILLARD AVE",
            "city": "GENOA",
            "state": "NE",
            "postal_code": "686403039",
            "telephone_number": "402-993-2400",
            "fax_number": "402-993-2421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENOA COMMUNITY PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-06",
        "last_updated": "2014-09-22",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PHARMACIST/OWNER",
        "authorized_official_telephone_number": "402-366-1417"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NE",
            "license": "2928",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2118928",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025721600",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Geneoa Community Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Genoa, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 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.