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
701 SHADOW LN STE 110, LAS VEGAS, NV 89106-4131
(702) 382-4176
(702) 382-4822
Mailing address
707 S GRADY WAY STE 400, RENTON, WA 98057-3246
(877) 719-6349
(877) 719-6362
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
3336S0011X
Specialty Pharmacy
Primary
—
—
Other
Enumeration date
03/11/2009
Last updated
12/24/2024
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