Healthcare Provider Details

I. General information

NPI: 1033414842
Provider Name (Legal Business Name): INNOVAHEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2011
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4145 ROUTE 286 HWY W
INDIANA PA
15701-5727
US

IV. Provider business mailing address

645 KOLTER DR
INDIANA PA
15701-3570
US

V. Phone/Fax

Practice location:
  • Phone: 724-599-2510
  • Fax: 724-599-3999
Mailing address:
  • Phone: 724-349-1111
  • Fax: 724-349-2604

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License NumberPP482002
License Number StatePA

VIII. Authorized Official

Name: MR. MARK JOSEPH ZILNER
Title or Position: PRESIDENT
Credential: R.PH.
Phone: 724-349-1111