Organization
GENOA HEALTHCARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NATASHA HENNESSY (CHIEF PHARMACY OFFICER)
(612) 722-4249
Entity
Organization
Contact information
Practice address
1547 OHIO AVE, ANDERSON, IN 46016-1917
(765) 203-2126
(765) 649-2640
Mailing address
4900 PERRY HWY, BLDG 2, PITTSBURGH, PA 15229-2220
(412) 931-3131
(412) 931-2361
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
60006256A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2130524
PK
—
Enumeration date
06/02/2011
Last updated
04/26/2021
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