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
2417 MARSHALL AVE STE 3, IMPERIAL, CA 92251-9401
(760) 483-9099
(760) 585-4591
Mailing address
707 S GRADY WAY STE 400, RENTON, WA 98057-3246
(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
06/23/2021
Last updated
01/19/2024
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