Organization · NPI-2
Genoa Healthcare LLC
Pharmacy, Long Term Care Pharmacy · Fremont, NE
NPI number1922626423
StatusActive
Last updated in NPPESJan 18, 2024
Details
- NPI
- 1922626423
- Entity type
- Organization (NPI-2)
- Legal business name
- Genoa Healthcare LLC
- Organization subpart
- No
- Enumeration date
- Jul 10, 2020
- Certification date
- Jan 18, 2024
- Last updated
- Jan 18, 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
2740 N Clarkson St Ste P1Fremont, NE 68025-7703
Phone 402-289-8533 · Fax 402-850-2361
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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