Organization
GENESIS PHARMACY CORP
Active
Other names
ENOVA CARE PHARMACY, The Medicine Shoppe
Organization subpart
No
Provider details
NPI number
Authorized official
FADY MOSAAD (CEO)
(951) 245-1373
Entity
Organization
Contact information
Practice address
31946 MISSION TRL STE A1, LAKE ELSINORE, CA 92530-4539
(559) 358-5873
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
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Enumeration date
02/07/2019
Last updated
03/23/2026
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