Organization
GENOA HEALTHCARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NATASHA HENNESSY (CHIEF PHARMACY OFFICER)
(651) 302-3111
Entity
Organization
Contact information
Practice address
1101 N CENTRAL AVE, PHOENIX, AZ 85004-1808
(253) 218-0830
Mailing address
707 S GRADY WAY STE 700, RENTON, WA 98057-3243
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Enumeration date
05/25/2021
Last updated
05/25/2021
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