Genoa Healthcare LLC
Organization Active NPI Long Term Care Pharmacy · Montgomery, AL
NPI 1073993259 · NPPES record last updated Dec 17, 2024
Key facts
- NPI
- 1073993259
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Long Term Care Pharmacy 3336L0003X
- Legal business name
- GENOA HEALTHCARE LLC
- Practice address
- 2140 Upper Wetumpka Rd
Montgomery, AL 36107-1342 - Phone
- (334) 819-4581
- Fax
- (334) 356-7983
- NPI assigned
- Jun 3, 2015
- Organization subpart
- No
Authorized official
- Name
- Karen Bohmer
- Title
- Secretary
- Phone
- (224) 231-1833
Other NPIs on the same Medicare enrollment 5
Corporate family (same tax ID) 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200917001175 | AL | Part B Supplier - Pharmacy | 6608003652 |
6 other NPIs on this enrollment Practice locations: Attalla, AL; Bessemer, AL; Dothan, AL; Mobile, AL; Montgomery, AL; Scottsboro, AL |
National Provider Directory
- Tax ID family
- Genoa Healthcare LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Long Term Care Pharmacy | 3336L0003X | Yes |
Addresses
Primary practice location
2140 Upper Wetumpka Rd
Montgomery, AL 36107-1342
Mailing address
707 S Grady Way Ste 400
Renton, WA 98057-3246
Phone (253) 218-0830
Other providers in Montgomery, AL
- GD Al SDR PLLC
- GD Al Zelda PLLC
- Walter Thomas Geary Jr.
- Christopher Robin Gehling
- Generational Care LLC
- Gentle Care of Montgomery
- Chloe Gentle
- Jason K Gentry
- George W. Demuth, M.D. LLC.
- Shundreya George-Jefferson
All providers in Montgomery, AL · Long Term Care Pharmacy in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 17, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.