Organization
GENOA HEALTHCARE LLC
Active
Other names
Genoa Healthcare, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN BOHMER (SECRETARY)
(224) 231-1833
Entity
Organization
Contact information
Practice address
5818 COLUMBIA AVE STE P, HAMMOND, IN 46320-2607
(219) 228-8531
(219) 359-2968
Mailing address
707 S GRADY WAY STE 700, RENTON, WA 98057-3243
(253) 218-0830
(253) 217-4306
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
60006669A
IN
Other
Enumeration date
10/17/2017
Last updated
03/21/2023
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