MEDICARE: GENESIS PHARMACY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	25156	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2099444	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922019413
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GENESIS PHARMACY INC

Provider Business Mailing Address
First Line	:	1611 SPENCER HWY STE F
Second Line	:
City	:	SOUTH HOUSTON
State	:	TX
Zip	:	77587-3714
Country	:	US
Telephone Number	:	832-925-8797
Fax Number	:	832-925-8782

Provider Business Practice Location Address
First Line	:	1611 SPENCER HWY STE F
Second Line	:
City	:	SOUTH HOUSTON
State	:	TX
Zip	:	77587-3714
Country	:	US
Telephone Number	:	832-925-8797
Fax Number	:	832-925-8782

Authorized Official
Title or Position	:	OWNER
Name	:	JOHN HAGE
Credential	:	RPH
Telephone Number	:	832-925-8797

Provider Enumeration Date	:	08/10/2006
Last Update Date	:	11/08/2018

Similar Medicare Providers

1174672703 — MS. FANG YU GREENBERG L.AC.
Practice Location Address:

311 LINDEN AVE
SOUTH SAN FRANCISCO, CA
94080-3714

Practice Phone: 650-588-5685
Practice Fax: 650-588-5690

1356573117 — LINDSAY POWELL LOMBARDO D.O.
Practice Location Address:

1008 SOUTH SPRING AVE , SLUCARE ACADEMIC PAVILLION, 1ST FLOOR
SAINT LOUIS, MO
63110-3714

Practice Phone: 314-977-3470
Practice Fax: 314-977-1642

1003191891 — NAZLI SIDDIQUI PHARM D.
Practice Location Address:

2506 FIELDS SOUTH DR APT 201
CHAMPAIGN, IL
61822-3714

Practice Phone: 217-607-2522
Practice Fax:

1528308863 — MISS DAWN MARIE EINFELDT OTA6429
Practice Location Address:

1430 ISLAND DR S , APT/SUITE
SOUTH PASADENA, FL
33707-3714

Practice Phone: 727-560-4624
Practice Fax:

1912452020 — JACKI GOLDSTEIN M.D.
Practice Location Address:

40 OLD FARMS RD
SOUTH GLASTONBURY, CT
06073-3714

Practice Phone: 860-833-5732
Practice Fax:

1972099414 — MR. ANDREW SPENCER VITALE LMSW
Practice Location Address:

12314 149TH AVE
SOUTH OZONE PARK, NY
11420-3714

Practice Phone: 347-784-2867
Practice Fax:

Directions to “GENESIS PHARMACY INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.