# GENOA HEALTHCARE LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1457645665
- **Authorized official:** KAREN BOHMER (SECRETARY)
- **Authorized official phone:** (224) 231-1833

## Contact information

- **Practice address:** 8119 HOLLAND RD, ALEXANDRIA, VA 22306-3135
- **Practice address phone:** (703) 253-7697
- **Practice address fax:** (703) 799-2809
- **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 |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 06/06/2011
- **Last updated:** 03/29/2024