# GENOA HEALTHCARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164657060
- **Authorized official:** KAREN BOHMER (SECRETARY)
- **Authorized official phone:** (224) 231-1833

## Contact information

- **Practice address:** 6440 NIEMAN RD, SHAWNEE, KS 66203-3326
- **Practice address phone:** (913) 268-3610
- **Practice address fax:** (913) 268-3341
- **Mailing address:** 707 S GRADY WAY STE 400, RENTON, WA 98057-3246
- **Mailing address phone:** (253) 218-0830
- **Mailing address fax:** (253) 217-4306

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 333600000X | Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 05/20/2009
- **Last updated:** 01/26/2024