GENOA HEALTHCARE LLC – Long Term Care Pharmacy, NPI 1043278229
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
530 N MAIN ST STE 6
PROVIDENCE, RI 029045762
Phone: (401) 276-6370
Fax: (401) 276-6372
Type: Location
707 S GRADY WAY STE 700
RENTON, WA 980573243
Phone: (253) 218-0830
Fax: (253) 217-4306
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20201020001743 | O | Pharmacy | RI | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
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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