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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 | |
Community/Retail Pharmacy |
3336C0003X | 58 | Medical Supply Company with Pharmacist | |
Pharmacy |
333600000X | 58 | Medical Supply Company with Pharmacist |
| NPI Number | 1477954162 |
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| LBN Legal business name | GENOVATIONS PHARMACY LLC | ||||||||
| Authorized official | CLAUDIA KIM - (PHARMACY OPERATIONS MANAGER) | ||||||||
| Entity | Organization | ||||||||
| Organization subpart 1 | No | ||||||||
| Enumeration date | 09/12/2014 | ||||||||
| Last updated | 05/05/2015 - About 11 years ago | ||||||||
| Identifiers |
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GENOVATIONS PHARMACY LLC