GENOA HEALTHCARE, LLC
420 Bell Ave Ste P
Chattanooga, TN 37405
423-648-4310
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
N | 332B00000X | Suppliers - Durable Medical Equipment & Medical Supplies - | ||
N | 333600000X | Suppliers - Pharmacy | ||
N | 3336C0003X | Suppliers - Pharmacy | ||
Y | 3336L0003X | Suppliers - Pharmacy | TN | 4241 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
177566407 | AR | MEDICAID | |
1455179 | TN | MEDICAID | |
NCPDP PROVIDER IDENTIFICATION NUMBER | 4439053 | OTHER | |
BOP LICENSE | 4241 | TN | OTHER |