Genoa Healthcare LLC
Pharmacy, Long Term Care Pharmacy in Charlestown, MA. Organization (NPI-2).
NPI number1063959633
StatusActive
Last updated in NPPESJan 17, 2024
Details
- NPI
- 1063959633
- Entity type
- Organization (NPI-2)
- Legal business name
- Genoa Healthcare LLC
- Organization subpart
- No
- Enumeration date
- Jan 20, 2017
- Certification date
- Jan 17, 2024
- Last updated
- Jan 17, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3336L0003X | Pharmacy, Long Term Care Pharmacy | – | – | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | – | – | |
| 333600000X | Pharmacy | – | – | |
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | – | – |
Practice location
330 Rutherford Ave Ste 1Charlestown, MA 02129-2932
Phone 617-681-7107 · Fax 617-326-5123
Mailing address
707 S Grady Way Ste 400Renton, WA 98057-3246
Phone 253-218-0830 · Fax 253-217-4306
Authorized official
Karen Bohmer
Secretary
2242311833
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