Active NPI
Genoa Healthcare LLC
- Long Term Care Pharmacy
- Tamarac, FL
National Provider Identifier
1205211356
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Long Term Care Pharmacy
- Legal business name
- GENOA HEALTHCARE LLC
- Practice address
- 2900 W Prospect Rd # a
Tamarac, FL 33309-2519 - Phone
- (754) 216-4844
- Fax
- (954) 485-9044
- NPI assigned
- Jul 29, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Karen Bohmer
- Title
- Secretary
- Phone
- (224) 231-1833
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | |||
| Long Term Care Pharmacy | 3336L0003X | Primary |
Addresses
Primary practice location
2900 W Prospect Rd # a
Tamarac, FL 33309-2519
Mailing address
707 S Grady Way Ste 400
Renton, WA 98057-3246
Phone (253) 218-0830
National Provider Directory
National Provider DirectoryNetworks
- Optimum HealthCare HMO Network
- HealthSun Health Plans Network
- Freedom Health HMO Network
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Tamarac, FL
- NPI 1386125813
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1438128000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1735171200000",
"number": "1205211356",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "707 S GRADY WAY STE 400",
"city": "RENTON",
"state": "WA",
"postal_code": "980573246",
"telephone_number": "253-218-0830",
"fax_number": "253-217-4306"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2900 W PROSPECT RD # A",
"city": "TAMARAC",
"state": "FL",
"postal_code": "333092519",
"telephone_number": "754-216-4844",
"fax_number": "954-485-9044"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GENOA HEALTHCARE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2015-07-29",
"last_updated": "2024-12-26",
"certification_date": "2024-12-26",
"status": "A",
"authorized_official_last_name": "BOHMER",
"authorized_official_first_name": "KAREN",
"authorized_official_title_or_position": "SECRETARY",
"authorized_official_telephone_number": "224-231-1833"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336L0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Long Term Care Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tamarac, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.