Organization · NPI-2

Genoa Healthcare LLC

Pharmacy, Long Term Care Pharmacy · Sioux City, IA

NPI number1841908837

StatusActive

Last updated in NPPESJan 29, 2024

Details

NPI: 1841908837
Entity type: Organization (NPI-2)
Legal business name: Genoa Healthcare LLC
Organization subpart: No
Enumeration date: Nov 9, 2022
Certification date: Jan 29, 2024
Last updated: Jan 29, 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

3549 Southern Hills Dr Ste P
Sioux City, IA 51106-4736

Phone 712-454-6393 · Fax 712-454-7764

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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