Genoa Healthcare LLC
Pharmacy, Long Term Care Pharmacy in New London, CT. Organization (NPI-2).
NPI number1548469729
StatusActive
Last updated in NPPESDec 24, 2024
Details
- NPI
- 1548469729
- Entity type
- Organization (NPI-2)
- Legal business name
- Genoa Healthcare LLC
- Organization subpart
- No
- Enumeration date
- Jul 17, 2007
- Certification date
- Dec 24, 2024
- Last updated
- Dec 24, 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
21 Montauk Ave Ste 102New London, CT 06320-4906
Phone 860-447-9145 · Fax 860-271-8419
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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