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.
Organization
GENOA HEALTHCARE, LLC
Active
Organization
GENOA HEALTHCARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NATASHA HENNESSY (CHIEF PHARMACY OFFICER)
(612) 722-4249
Entity
Organization
Contact information
Practice address
526 W STATE ST, ROCKFORD, IL 61101-1214
(815) 962-8192
(815) 962-5703
Mailing address
PO BOX 77030, MINNEAPOLIS, MN 55480-7730
(253) 218-0830
(253) 217-4306
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
58013565
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1480057
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
743152173002
—
IL
Enumeration date
09/13/2006
Last updated
04/27/2021
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up