# GRANE SUPPLY, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** GraneRx
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962867077
- **Authorized official:** MR. HERBERT H HENNELL (VICE PRESIDENT OF REIMBURSEMENT)
- **Authorized official phone:** (412) 963-9150

## Contact information

- **Practice address:** 550 E UNION ST, SUITE B, WEST CHESTER, PA 19382-3908
- **Practice address phone:** (610) 918-4740
- **Practice address fax:** (412) 968-5800
- **Mailing address:** 105 GAMMA DR, SUITE 100, PITTSBURGH, PA 15238-2950
- **Mailing address phone:** (412) 449-0680
- **Mailing address fax:** (412) 968-5800

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 332BN1400X | Nursing Facility Supplies (DME) | — | NULL | — |
| 332BP3500X | Parenteral & Enteral Nutrition Supplies (DME) | — | NULL | — |
| 333600000X | Pharmacy | PP482615 | PA | — |
| 3336L0003X | Long Term Care Pharmacy | PP482615 | PA | Yes |

## Other

- **Enumeration date:** 12/17/2015
- **Last updated:** 11/04/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100761105-0009 | — | PA |