NPIMap

Organization Active NPI

Genoa Healthcare LLC

  • Long Term Care Pharmacy
  • Brockton, MA
National Provider Identifier
1992521512
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
GENOA HEALTHCARE LLC
Practice address
795 Pleasant Street
Suite P
Brockton, MA 02301-3052
Phone
(508) 580-8701
Fax
(508) 630-0281
NPI assigned
Nov 27, 2024
Last updated
May 1, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2025

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

Authorized official

Name
Karen Bohmer
Title
Secretary
Phone
(224) 231-1833

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

795 Pleasant Street
Suite P
Brockton, MA 02301-3052

Mailing address

707 S Grady Way
Ste 400
Renton, WA 98057
Phone (253) 218-0830

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200519002331 MA Part B Supplier - Pharmacy 6608003652 22 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Framingham, MA; Worcester, MA; West Springfield, MA; Springfield, MA; Quincy, MA; Northampton, MA; Milford, MA; Marlborough, MA…

Other NPIs on the same Medicare enrollment 20

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

View all 20

National Provider Directory

National Provider Directory
Tax ID family
Genoa Healthcare LLC757 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.

Member of 1

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

Locations (25 of 384)

4020 Folker St
Ste 5
Anchorage, AK 99508
Phone (907) 891-7079

425 5th Ave NW
Rm 92
Attalla, AL 35954
Phone (256) 413-4455

2201 Arlington Ave
Ste B
Bessemer, AL 35020
Phone (256) 764-7201

3456 Hillcrest Rd
Ste D
Mobile, AL 36695
Phone (251) 665-4521

2520 Fairlane Dr
Ste 300
Montgomery, AL 36116
Phone (334) 356-7627

715 N College Ave
Ste P1
El Dorado, AR 71730
Phone (870) 639-6227

125 Wellness Way
Ste 268
Hot Springs National Park, AR 71913
Phone (501) 762-8919

2904 Arkansas Blvd
Ste 116
Texarkana, AR 71854
Phone (870) 397-8985

2705 Oak Ln
#B
Van Buren, AR 72956
Phone (479) 343-6002

824 N 99th Ave
Ste 106
Avondale, AZ 85323
Phone (602) 899-4911

121 W 2nd St
Ste 1
Casa Grande, AZ 85122
Phone (520) 413-0262

1465 W Chandler Blvd
Ste P
Chandler, AZ 85224
Phone (623) 208-7646

3271 E Queen Creek Rd
Ste 101P
Gilbert, AZ 85297
Phone (602) 748-4220

5222 E Baseline Rd
Ste 100
Gilbert, AZ 85234
Phone (480) 485-5939

5720 W Peoria Ave
Ste 103
Glendale, AZ 85302
Phone (623) 265-5729

915 Airway Ave
Ste B
Kingman, AZ 86409
Phone (928) 377-1741

325 N Stapley Dr
Ste P
Mesa, AZ 85203
Phone (623) 399-4265

334 W 10th Pl
Ste 101
Mesa, AZ 85201
Phone (480) 824-0109

4631 S Power Rd
Ste 105
Mesa, AZ 85212
Phone (480) 750-1635

10240 N 31st Ave
Ste 210
Phoenix, AZ 85051
Phone (602) 384-9992

10844 N 23rd Ave
Ste P125
Phoenix, AZ 85029
Phone (480) 372-2858

1515 E Osborn Rd
Ste P1
Phoenix, AZ 85014
Phone (623) 432-1975

2311 W Royal Palm Rd
Ste P
Phoenix, AZ 85021
Phone (480) 867-3743

3001 N 33rd Ave
Rm 210
Phoenix, AZ 85017
Phone (480) 422-3283

3227 E Bell Rd
Ste 170
Phoenix, AZ 85032
Phone (480) 719-7383

Practitioners & affiliated clinicians

Practitioners 289

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.

View all 289

NPI Registry JSON

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

{
    "created_epoch": "1732665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746057600000",
    "number": "1992521512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 S GRADY WAY",
            "address_2": "STE 400",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "98057",
            "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": "795 PLEASANT STREET",
            "address_2": "SUITE P",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023013052",
            "telephone_number": "508-580-8701",
            "fax_number": "508-630-0281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENOA HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-27",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A",
        "authorized_official_last_name": "BOHMER",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "224-231-1833"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.