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A pharmacy owned by a managed care organization (MCO) used by pharmacists for the compounding and dispensing of medicinal preparations to that MCO?s covered members only.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Managed Care Organization Pharmacy |
3336M0003X | 58 | Medical Supply Company with Pharmacist | |
Long Term Care Pharmacy |
3336L0003X | 58 | Medical Supply Company with Pharmacist | |
Pharmacy |
333600000X | 58 | Medical Supply Company with Pharmacist |
| NPI Number | 1215445085 |
| LBN Legal business name | GENOA HEALTHCARE LLC |
| Authorized official | KAREN BOHMER - (SECRETARY) |
| Entity | Organization |
| Organization subpart 1 | Yes |
| Enumeration date | 01/16/2018 |
| Last updated | 03/24/2023 - About 3 years ago |
| Identifiers | n/a |
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GENOA HEALTHCARE LLC
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GENOA HEALTHCARE LLC