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
101 BOULDER POINT DR RM 1009, PLYMOUTH, NH 03264-3170
(603) 346-4481
(603) 346-4488
Mailing address
700 S GRADY WAY STE 400, RENTON, WA 98057-3238
(253) 218-0830
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Enumeration date
10/17/2017
Last updated
01/26/2024
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