NPIMap

Organization Active NPI

Grane Supply, Inc.

  • Long Term Care Pharmacy
  • West Chester, PA
National Provider Identifier
1962867077
Registry record updated Nov 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
PP482615 Issued in PA
Legal business name
GRANE SUPPLY, INC.
Practice address
550 E Union St
Suite B
West Chester, PA 19382-3908
Phone
(610) 918-4740
Fax
(412) 968-5800
NPI assigned
Dec 17, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Herbert H Hennell
Title
Vice President of Reimbursement
Phone
(412) 963-9150

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Nursing Facility Supplies (DME) 332BN1400X
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X
Pharmacy 333600000X PP482615 PA
Long Term Care Pharmacy 3336L0003X PP482615 PA Primary

Addresses

Primary practice location

550 E Union St
Suite B
West Chester, PA 19382-3908

Mailing address

105 Gamma Dr
Suite 100
Pittsburgh, PA 15238-2950
Phone (412) 449-0680

Other identifiers 1

IdentifierTypeStateIssuer
100761105-0009MedicaidPA

Other names 1

  • GraneRx Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20210908003345 PA Part B Supplier - Pharmacy 2668592379 Practice locations: West Chester, PA
O20210921002597 PA Part B Supplier - Mass Immunization (Roster Biller Only) 2668592379 2 other NPIs on this enrollment
Practice locations: Lima, PA; Pittsburgh, PA; West Chester, PA
O20211207001674 PA DME Supplier - Pharmacy 2668592379 Practice locations: West Chester, PA

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Grane Supply Inc550 E Union St, West Chester, PA 19382-3908(888) 515-2640 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Jan 1, 1998

National Provider Directory

National Provider Directory
Tax ID family
Grane Supply Clinical L4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

105 Gamma Dr
Ste 100
Pittsburgh, PA 15238
Phone (412) 449-0680

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1450310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572825600000",
    "number": "1962867077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 GAMMA DR",
            "address_2": "SUITE 100",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152382950",
            "telephone_number": "412-449-0680",
            "fax_number": "412-968-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 E UNION ST",
            "address_2": "SUITE B",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "193823908",
            "telephone_number": "610-918-4740",
            "fax_number": "412-968-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANE SUPPLY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-17",
        "last_updated": "2019-11-04",
        "status": "A",
        "authorized_official_last_name": "HENNELL",
        "authorized_official_first_name": "HERBERT",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "VICE PRESIDENT OF REIMBURSEMENT",
        "authorized_official_telephone_number": "412-963-9150",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BN1400X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "PA",
            "license": "PP482615",
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "PA",
            "license": "PP482615",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100761105-0009",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GraneRx",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "GraneRx",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Chester, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.