Organization
INNOVAGE PENNSYLVANIA LIFE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GAYLE M WASHINGTON (CREDENTIALING DIRECTOR)
(303) 912-7193
Entity
Organization
Contact information
Practice address
6950 GERMANTOWN AVE, PHILADELPHIA, PA 19119
(215) 951-4304
(267) 286-4910
Mailing address
6950 GERMANTOWN AVE, PHILADELPHIA, PA 19119-2114
(215) 951-4304
(267) 286-4910
Taxonomy
Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1017342560001
—
PA
Enumeration date
02/28/2007
Last updated
04/04/2019
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us