Genoa Healthcare LLC

Organization Active NPI Long Term Care Pharmacy · Attalla, AL

NPI 1225418403 · NPPES record last updated Dec 17, 2024

Key facts

NPI
1225418403
Entity type
Organization (NPI type 2)
Primary specialty
Long Term Care Pharmacy 3336L0003X
Legal business name
GENOA HEALTHCARE LLC
Practice address
425 5TH Ave NW RM 92
Attalla, AL 35954-2214
Phone
(256) 413-4455
Fax
(256) 413-4477
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

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Corporate family (same tax ID) 5

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in AL

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20200917001175 AL Part B Supplier - Pharmacy 6608003652 6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Attalla, AL; Bessemer, AL; Dothan, AL; Mobile, AL; Montgomery, AL; Scottsboro, AL

National Provider Directory

Tax ID family
Genoa Healthcare LLC (759 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X Yes

Addresses

Primary practice location

425 5TH Ave NW RM 92
Attalla, AL 35954-2214

Mailing address

707 S Grady Way Ste 400
Renton, WA 98057-3246
Phone (253) 218-0830

Other providers in Attalla, AL

All providers in Attalla, AL · Long Term Care Pharmacy in Alabama

Sources for this page

Verify at the official NPI Registry.