| NPI | 1194216713 |
|---|---|
| Doing Business As | GENOA HEALTHCARE, LLC |
| Entity Type | Organization |
| Authorized Contact | JOSEPH DOUGLAS CEO 815-404-4871 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0003X Pharmacy, Community/Retail Pharmacy | |
| Enumeration Date | 2018-05-21 |
| Last Update Date | 2022-06-28 |