Organization
GENOA HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN BOHMER (SECRETARY)
(224) 231-1833
Entity
Organization
Contact information
Practice address
215 N 3RD ST, LEESBURG, FL 34748-5105
(352) 702-0079
(352) 702-3276
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
332B00000X
Durable Medical Equipment & Medical Supplies
—
FL
333600000X
Pharmacy
—
FL
3336L0003X
Long Term Care Pharmacy
Primary
—
FL
Other
Enumeration date
01/13/2011
Last updated
01/24/2024
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