NPI 1104954569

Innovage Pennsylvania Life, LLC

Organisation PACE Provider Organization Philadelphia, PA

Practice location

Address: 6950 Germantown Ave, Philadelphia, PA 19119
Phone: (215) 951-4304
Fax: (267) 286-4910
Mailing address: 6950 Germantown Ave, Philadelphia, PA 19119-2114

Authorised official

Name: Gayle M Washington
Title: Credentialing Director
Phone: (303) 912-7193

Registered specialties

PACE Provider Organization Primary

Agencies Taxonomy 251T00000X

Other Program of All-Inclusive Care for the Elderly (PACE) Provider Organization providers in Pennsylvania →

Registry record

NPI: 1104954569
Entity type: Organization
NPI issued: 28 Feb 2007
Record last updated: 4 Apr 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.