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Contact Information

GENOA HEALTHCARE, LLC
445 S LANDMARK AVE STE P
BLOOMINGTON, IN47403-5004
 Phone: 253-218-0830
 Fax: 253-217-4306
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Long Term Care Pharmacy

3336L0003X 58 Medical Supply Company with Pharmacist
 

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for GENOA HEALTHCARE, LLC

NPI Number 1437697935
LBN Legal business name GENOA HEALTHCARE, LLC
Authorized official NATASHA HENNESSY - (CHIEF PHARMACY OFFICER)
Entity Organization
Organization subpart 1 No
Enumeration date 02/03/2017
Last updated 04/26/2021 - About 5 years ago
Identifiers
Other 2169084 PK
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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