NPIMap

Organization Active NPI

Professionals PRN LLC

  • Home Infusion Therapy Pharmacy
  • Zanesville, OH
National Provider Identifier
1003859067
Registry record updated Apr 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Infusion Therapy PharmacyTaxonomy code 3336H0001X
License
021068550 Issued in OH
Legal business name
PROFESSIONALS PRN LLC
Doing business as
NORTHSIDE HOME INFUSION
Practice address
21 N Maysville Ave
Zanesville, OH 43701-6110
Phone
(740) 452-2447
Fax
(740) 452-1399
NPI assigned
Jun 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2021

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

Authorized official

Name
Edward Jay Stoepfel
Title
Director
Phone
(740) 454-5666

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Compounding Pharmacy 3336C0004X
Home Infusion Therapy Pharmacy 3336H0001X 021068550 OH Primary

Addresses

Primary practice location

21 N Maysville Ave
Zanesville, OH 43701-6110

Mailing address

21 N Maysville Ave
Zanesville, OH 43701-6110
Phone (740) 452-2447

Other identifiers 2

IdentifierTypeStateIssuer
2056902MedicaidOH
2077516OtherPK

Other names 1

  • NORTHSIDE HOME INFUSION Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930014057 OH DME Supplier - PharmacyDME Supplier - Medical Supply Company With Registered Pharmacist 2860510195 Practice locations: Zanesville, OH

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory
Tax ID family
Professionals PRN LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

21 N Maysville Ave
Zanesville, OH 43701
Phone (740) 452-2447

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619308800000",
    "number": "1003859067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 N MAYSVILLE AVE",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "437016110",
            "telephone_number": "740-452-2447",
            "fax_number": "740-452-1399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 N MAYSVILLE AVE",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "437016110",
            "telephone_number": "740-452-2447",
            "fax_number": "740-452-1399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONALS PRN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-14",
        "last_updated": "2021-04-25",
        "certification_date": "2021-04-25",
        "status": "A",
        "authorized_official_last_name": "STOEPFEL",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "JAY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "740-454-5666"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": "OH",
            "license": "021068550",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2056902",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2077516",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NORTHSIDE HOME INFUSION",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "NORTHSIDE HOME INFUSION",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Zanesville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.