Genoa Healthcare LLC
Organization Active NPI Long Term Care Pharmacy · Monessen, PA
NPI 1083261069 · NPPES record last updated Jan 25, 2024
Key facts
- NPI
- 1083261069
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Long Term Care Pharmacy 3336L0003X
- Legal business name
- GENOA HEALTHCARE LLC
- Practice address
- 2 Eastgate Ave Ste P
Monessen, PA 15062-1393 - Phone
- (724) 653-6038
- Fax
- (724) 987-7278
- NPI assigned
- Aug 23, 2019
- Organization subpart
- No
Authorized official
- Name
- Karen Bohmer
- Title
- Secretary
- Phone
- (224) 231-1833
Other NPIs on the same Medicare enrollment 27
Corporate family (same tax ID) 17
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200922000829 | PA | Part B Supplier - Pharmacy | 6608003652 |
28 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Philadelphia, PA; New Castle, PA; Pittsburgh, PA; Pottstown, PA; Reading, PA; Sellersville, PA; Somerset, PA; Warren, PA… |
National Provider Directory
- Tax ID family
- Genoa Healthcare LLC
Locations
2 Eastgate Ave
Ste P
Monessen, PA 15062
Phone (724) 653-6038
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | |||
| Long Term Care Pharmacy | 3336L0003X | Yes |
Addresses
Primary practice location
2 Eastgate Ave Ste P
Monessen, PA 15062-1393
Mailing address
707 S Grady Way Ste 400
Renton, WA 98057-3246
Phone (253) 218-0830
Other providers in Monessen, PA
- For Your Health LLC
- Diane Guenin Fox
- Christopher Ryan Freeborough
- Lauren Gagatko
- Chris A Garrett
- Jenna B Gilbert
- Dionne Lerae Gill
- Grassroutes Counseling Services, LLC
- Taylor Ann Guidish
- Paulette Tirpak Hamilton
All providers in Monessen, PA · Long Term Care Pharmacy in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 25, 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.