Organization · NPI-2

Genoa Healthcare LLC

Pharmacy, Long Term Care Pharmacy · Bullhead City, AZ

NPI number1144983206

StatusActive

Last updated in NPPESJan 16, 2024

Details

NPI: 1144983206
Entity type: Organization (NPI-2)
Legal business name: Genoa Healthcare LLC
Organization subpart: No
Enumeration date: Oct 15, 2021
Certification date: Jan 16, 2024
Last updated: Jan 16, 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

2580 Az-95
Suite 119-P
Bullhead City, AZ 86442

Phone 928-444-8640 · Fax 928-237-4553

Mailing address

707 S Grady Way Ste 400
Renton, WA 98057-3246

Phone 253-218-0830 · Fax 253-217-4306

Authorized official

Karen Bohmer
Secretary
2242311833

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