GENOA HEALTHCARE LLC – Long Term Care Pharmacy, NPI 1003874652
Long Term Care Pharmacy
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for GENOA HEALTHCARE LLC
PO BOX 77030
MINNEAPOLIS, MN 554807730
Phone: (253) 218-0830
Fax: (253) 217-4306
Type: Mailing
707 S GRADY WAY STE 400
RENTON, WA 980573246
Phone: (253) 218-0830
Fax: (253) 217-4306
Type: Mailing
707 S GRADY WAY STE 700
RENTON, WA 980573243
Phone: (253) 218-0830
Fax: (253) 217-4306
Type: Mailing
12 N 64TH ST STE 6
BELLEVILLE, IL 622233809
Phone: (618) 398-5127
Fax: (618) 398-5582
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2020-04-15
PECOS data refreshed: 2026-05-27
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 55480)
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