Genoa Healthcare – Long Term Care Pharmacy, NPI 1962929505
Long Term Care Pharmacy
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Genoa Healthcare
PO BOX 77030
MINNEAPOLIS, MN 554807730
Phone: (253) 218-0830
Fax: (253) 217-4306
Type: Mailing
West Central Park Avenue, Davenport, Scott County, Iowa, 52804, United States
DAVENPORT, IA 528041707
Phone: (563) 265-6955
Fax: (563) 275-3296
Type: Location
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
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.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2020-10-19
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Revalidation due soon
Earliest CMS due date is 2026-08-31 (81 days away).
Enrollment records
1
Earliest due date
2026-08-31
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 |
|---|---|---|---|---|
| O20200728000690 | O | Pharmacy | IA | 2026-08-31 |
What to do next
- Confirm the due date on the CMS Revalidation Lookup Tool.
- Complete revalidation in PECOS before the published due date.
- If you have multiple enrollment records, revalidate each one on its own schedule.
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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