Organization · NPI-2

Genoa Healthcare LLC

Pharmacy, Long Term Care Pharmacy · Sioux City, IA

NPI number1689208829
StatusActive
Last updated in NPPESJan 29, 2024

Details

NPI
1689208829
Entity type
Organization (NPI-2)
Legal business name
Genoa Healthcare LLC
Organization subpart
No
Enumeration date
Feb 26, 2020
Certification date
Jan 29, 2024
Last updated
Jan 29, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
3336L0003X Pharmacy, Long Term Care Pharmacy––Yes
332B00000X Durable Medical Equipment & Medical Supplies––
333600000X Pharmacy––
3336C0003X Pharmacy, Community/Retail Pharmacy––

Practice location

625 Court St Ste P
Sioux City, IA 51101-1919

Phone 712-266-3956 · Fax 712-258-6087

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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