Organization
GENOA HEALTHCARE OF MINNESOTA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JODI KERSAVAGE (SITE IMPLEMENTATION)
(360) 601-2122
Entity
Organization
Contact information
Practice address
825 S 8TH ST, SUITE SL-10, MINNEAPOLIS, MN 55404-1208
(612) 332-6522
Mailing address
510 E MAIN ST, AUBURN, WA 98002-5502
(360) 218-0830
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
262600-0
MN
Other
Enumeration date
05/03/2006
Last updated
08/22/2020
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