# GENOA HEALTHCARE, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Genoa, a QoL Healthcare Company, LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578007316
- **Authorized official:** NATASHA HENNESSY (CHIEF PHARMACY OFFICER)
- **Authorized official phone:** (612) 722-4249

## Contact information

- **Practice address:** 289 GREAT RD STE G1, ACTON, MA 01720-4826
- **Practice address phone:** (978) 631-2186
- **Practice address fax:** (978) 263-7974
- **Mailing address:** PO BOX 77030, MINNEAPOLIS, MN 55480-7730
- **Mailing address phone:** (253) 218-0830
- **Mailing address fax:** (253) 217-4306

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | DS90081 | MA | Yes |

## Other

- **Enumeration date:** 12/13/2016
- **Last updated:** 04/26/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 110104208B | — | MA |
| 01 | — | 2167383 | PK | — |