NPIMap

Organization Active NPI

Genoa Healthcare, LLC

  • Long Term Care Pharmacy
  • Atlanta, GA
National Provider Identifier
1992105589
Registry record updated Apr 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
PHRE010079 Issued in GA
Legal business name
GENOA HEALTHCARE, LLC
Practice address
23 Warren St SE
Atlanta, GA 30317-2201
Phone
(404) 508-6449
Fax
(404) 378-9298
NPI assigned
Sep 2, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2021

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

Authorized official

Name
Natasha Hennessy
Title
Chief Pharmacy Officer
Phone
(612) 722-4249

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X
Long Term Care Pharmacy 3336L0003X PHRE010079 GA Primary

Addresses

Primary practice location

23 Warren St SE
Atlanta, GA 30317-2201

Mailing address

PO Box 77030
Minneapolis, MN 55480-7730
Phone (253) 218-0830

Other identifiers 1

IdentifierTypeStateIssuer
2147833OtherPK

National Provider Directory

National Provider Directory
Tax ID family
Genoa Healthcare LLC759 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 12

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations

23 Warren St SE
Atlanta, GA 30317
Phone (404) 370-7474

NPI Registry JSON

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

{
    "created_epoch": "1409616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619481600000",
    "number": "1992105589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 77030",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554807730",
            "telephone_number": "253-218-0830",
            "fax_number": "253-217-4306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 WARREN ST SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303172201",
            "telephone_number": "404-508-6449",
            "fax_number": "404-378-9298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENOA HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-02",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A",
        "authorized_official_last_name": "HENNESSY",
        "authorized_official_first_name": "NATASHA",
        "authorized_official_title_or_position": "CHIEF PHARMACY OFFICER",
        "authorized_official_telephone_number": "612-722-4249"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "GA",
            "license": "PHRE010079",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2147833",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2021; 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.