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Organization
GENOA HEALTHCARE LLC
Active
Organization
GENOA HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN BOHMER (SECRETARY)
(224) 231-1833
Entity
Organization
Contact information
Practice address
4900 WYALUSING AVE RM 106/108, PHILADELPHIA, PA 19131-5127
(215) 764-6519
(215) 477-1537
Mailing address
707 S GRADY WAY STE 400, RENTON, WA 98057-3246
(253) 218-0830
(253) 217-4306
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
—
NULL
3336L0003X
Long Term Care Pharmacy
Primary
—
NULL
Other
Enumeration date
02/21/2019
Last updated
01/26/2024
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