# GENOA HEALTHCARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** GENOA HEALTHCARE LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1215445085
- **Legal business name:** GENOA HEALTHCARE LLC
- **Authorized official:** KAREN BOHMER (SECRETARY)
- **Authorized official phone:** (224) 231-1833

## Contact information

- **Practice address:** 8441 WAYZATA BLVD, SUITE 340, GOLDEN VALLEY, MN 55426-1372
- **Practice address phone:** (952) 746-8185
- **Practice address fax:** (952) 746-8187
- **Mailing address:** PO BOX 77030, MINNEAPOLIS, MN 55480-7730
- **Mailing address phone:** (253) 218-0830
- **Mailing address fax:** (253) 217-4306

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | — |
| 3336M0003X | Managed Care Organization Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 01/16/2018
- **Last updated:** 03/24/2023