Genoa Healthcare LLC
Organization Active NPI Long Term Care Pharmacy · Kent, OH
NPI 1154591998 · NPPES record last updated Dec 26, 2024
Key facts
- NPI
- 1154591998
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Long Term Care Pharmacy 3336L0003X
- Legal business name
- GENOA HEALTHCARE LLC
- Practice address
- 5982 Rhodes Rd
Kent, OH 44240-8100 - Phone
- (330) 673-8750
- Fax
- (330) 673-8756
- NPI assigned
- Mar 7, 2008
- Organization subpart
- No
Authorized official
- Name
- Karen Bohmer
- Title
- Secretary
- Phone
- (224) 231-1833
Corporate family (same tax ID) 16
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200706002489 | OH | Part B Supplier - Pharmacy | 6608003652 |
This NPI is an additional NPI on the enrollment Practice locations: Toledo, OH; Hamilton, OH; Kent, OH; Lima, OH; Mansfield, OH; Moraine, OH; Newark, OH; Perrysburg, OH… |
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
5982 Rhodes Rd
Kent, OH 44240-8100
Mailing address
707 S Grady Way Ste 400
Renton, WA 98057-3246
Phone (253) 218-0830
Other providers in Kent, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 26, 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.