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Suppliers Durable Medical Equipment & Medical Supplies

Provider NPI: 1124320080

Organization Information:
Organization Name:  GENOA HEALTHCARE, LLC
Organization is not Subpart
Authorized Official:  SARAH  FENWICK  VP NETWORK CONTRACTING  612-200-1765

Practice Location:
Tel: 401-237-4125  Fax: 401-903-0105

Business Mailing Address:
PO BOX 77030  MINNEAPOLIS, MN 55480-7730 US
Tel: 253-218-0830  Fax: 253-217-4306

NPI Information:
NPI: 1124320080
Entity Type: Organization


PrimaryCodeCategory/DescriptionStateLicense Number
Durable Medical Equipment & Medical Supplies

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 3336L0003X





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