Provider Demographics
NPI:1033414842
Name:INNOVAHEALTH, LLC
Entity Type:Organization
Organization Name:INNOVAHEALTH, LLC
Other - Org Name:INNOVASCRIPT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:ZILNER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:724-349-1111
Mailing Address - Street 1:645 KOLTER DR
Mailing Address - Street 2:
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-3570
Mailing Address - Country:US
Mailing Address - Phone:724-349-1111
Mailing Address - Fax:724-349-2604
Practice Address - Street 1:641 KOLTER DRIVE
Practice Address - Street 2:
Practice Address - City:INDIANA
Practice Address - State:PA
Practice Address - Zip Code:15701-3570
Practice Address - Country:US
Practice Address - Phone:724-599-2510
Practice Address - Fax:724-599-3999
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SAPPHIREHEALTH, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-01-26
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336L0003X
PAPP4820023336M0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy