Organization
GENOA HEALTHCARE LLC
Active
Other names
1st Avenue Pharmacy Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN BOHMER (SECRETARY)
(224) 231-1833
Entity
Organization
Contact information
Practice address
6 E 1ST AVE, SPOKANE, WA 99202-1503
(509) 624-3017
(509) 624-4330
Mailing address
707 S GRADY WAY STE 400, RENTON, WA 98057-3246
(253) 218-0830
(253) 217-4306
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Enumeration date
12/18/2006
Last updated
05/21/2024
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