Organization · NPI-2

Genoa Healthcare LLC

Pharmacy, Long Term Care Pharmacy · Farmington, MO

NPI number1265089262

StatusActive

Last updated in NPPESJul 30, 2025

Details

NPI: 1265089262
Entity type: Organization (NPI-2)
Legal business name: Genoa Healthcare LLC
Organization subpart: No
Enumeration date: Aug 23, 2019
Certification date: Jul 30, 2025
Last updated: Jul 30, 2025

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

1401 Maple St Ste P
Farmington, MO 63640-8066

Phone 573-747-4816 · Fax 573-606-3465

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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