Organization
GENOA HEALTHCARE OF DELAWARE, LLC
Active
Other names
Genoa Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN NIEMEYER (CONTROLLER)
(253) 218-0830
Entity
Organization
Contact information
Practice address
500 W 8TH ST STE 1, WILMINGTON, DE 19801-1408
(253) 218-0830
(253) 217-4306
Mailing address
PO BOX 77030, MINNEAPOLIS, MN 55480-7730
(253) 218-0830
(253) 217-4306
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
10/18/2012
Last updated
10/18/2012
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