Organization
GRANE SUPPLY, INC.
Active
Other names
GraneRx
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HERBERT H HENNELL (VICE PRESIDENT OF REIMBURSEMENT)
(412) 963-9150
Entity
Organization
Contact information
Practice address
550 E UNION ST, SUITE B, WEST CHESTER, PA 19382-3908
(610) 918-4740
(412) 968-5800
Mailing address
105 GAMMA DR, SUITE 100, PITTSBURGH, PA 15238-2950
(412) 449-0680
(412) 968-5800
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BN1400X
Nursing Facility Supplies (DME)
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
333600000X
Pharmacy
PP482615
PA
3336L0003X
Long Term Care Pharmacy
Primary
PP482615
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100761105-0009
—
PA
Enumeration date
12/17/2015
Last updated
11/04/2019
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