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Organization
GENOA HEALTHCARE LLC
Active
Organization
GENOA HEALTHCARE LLC
Active
Other names
Genoa Healthcare of Minnesota LLC
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN BOHMER (SECRETARY)
(224) 231-1833
Entity
Organization
Contact information
Practice address
1155 FORD RD STE C, ST LOUIS PARK, MN 55426
(612) 284-2197
(612) 808-6759
Mailing address
707 S GRADY WAY STE 400, RENTON, WA 98057-3246
(253) 218-0830
(253) 735-4741
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
333600000X
Pharmacy
—
NULL
3336L0003X
Long Term Care Pharmacy
Primary
—
NULL
Other
Enumeration date
10/11/2011
Last updated
12/24/2024
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