Organization
GENESIS PHARMACY CORP
Active
Other names
Enova Care Pharmacy LTC
Organization subpart
No
Provider details
NPI number
Authorized official
FADY MOSAAD RPH (CEO)
(951) 245-1373
Entity
Organization
Contact information
Practice address
31946 MISSION TRL STE A1, LAKE ELSINORE, CA 92530-4539
(951) 245-1373
(877) 489-1666
Mailing address
31946 MISSION TRL STE A1, LAKE ELSINORE, CA 92530-4539
(951) 245-1373
(877) 489-1666
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PHY57029
PHARMACY PERMIT
CA
Enumeration date
07/08/2026
Last updated
07/08/2026
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