Genoa Healthcare LLC
Pharmacy, Long Term Care Pharmacy in Edina, MN. Organization (NPI-2).
NPI number1245083369
StatusActive
Last updated in NPPESJul 16, 2024
Details
- NPI
- 1245083369
- Entity type
- Organization (NPI-2)
- Legal business name
- Genoa Healthcare LLC
- Organization subpart
- No
- Enumeration date
- Apr 9, 2024
- Certification date
- Jul 16, 2024
- Last updated
- Jul 16, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
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
4444 W 76th Street Suite 650 Room PEdina, MN 55435-5173
Phone 952-656-0022 · Fax 952-314-6632
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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