Organization
GENOA HEALTHCARE OF KENTUCKY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENISE JASON (CONTRACTS ADMINISTRATOR)
(253) 218-0862
Entity
Organization
Contact information
Practice address
201 MECHANIC ST, LEXINGTON, KY 40507-1004
(859) 389-6404
Mailing address
510 E MAIN ST, AUBURN, WA 98002-5502
(253) 218-0830
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
P07131
KY
3336L0003X
Long Term Care Pharmacy
Primary
P07131
KY
Other
Enumeration date
08/22/2007
Last updated
03/03/2008
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