GENOA HEALTHCARE LLC – Long Term Care Pharmacy, NPI 1063470599
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 700
RENTON, WA 980573243
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
1600 E OLIVE ST BLDG D
SEATTLE, WA 981222735
Phone: (425) 835-7110
Fax: (206) 325-5016
Type: Location
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)
Revalidation scheduled
Earliest CMS due date is 2026-09-30 (113 days away).
Enrollment records
1
Earliest due date
2026-09-30
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 |
|---|---|---|---|---|
| O20200917001317 | O | Pharmacy | WA | 2026-09-30 |
What to do next
- Monitor the published due date as it approaches.
- Plan to revalidate in PECOS within the window CMS allows before the due date.
- Verify the date on the CMS Revalidation Lookup Tool before submitting.
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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