Innovage Pennsylvania Life, Llc

LBN: Innovage Pennsylvania Life, Llc
Innovage Pennsylvania Life, Llc is an health care organization with primary practice located at 6950 Germantown Ave , Philadelphia PA 19119. The organization recently has only one registered license in Agencies / Program of All-Inclusive Care for the Elderly (PACE) Provider Organization, which is considered as the primary health care specialty. Innovage Pennsylvania Life, Llc can be contacted via phone (215) 951-4304, or through Washington, Gayle M via phone (303) 912-7193.

Contact Information

Primary practice address
6950 Germantown Ave Philadelphia PA 19119
Phone: (215) 951-4304
Fax: (267) 286-4910
Website:
Map and Directions
Authorized official contact:
Name: Washington, Gayle M
Phone: (303) 912-7193

Health care specialties

SpecialtyCodeLicense #State
Agencies / Program of All-Inclusive Care for the Elderly (PACE) Provider Organization 251T00000X

Profile Details

NPI number 1104954569
LBN Legal business name Innovage Pennsylvania Life, Llc
DBA Doing business as
Authorized official Washington, Gayle M
Entity Organization
Organization subpart 1 No
Enumeration date Feb 28th, 2007
Last updated Apr 4th, 2019 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104954569 NPPES
Pennsylvania MEDICAID 1017342560001

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