NPIMap

Organization Active NPI

PRN Pool Inc

  • Home Health Agency
  • Griffin, GA
National Provider Identifier
1063563112
Registry record updated May 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
DHR125R0002 Issued in GA
Legal business name
PRN POOL INC
Practice address
240 Odell Rd
Griffin, GA 30224-4787
Phone
(770) 227-1264
Fax
(770) 228-9986
NPI assigned
Jan 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2008

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

Authorized official

Name
Mr. Charles E Grogan
Title
Ceo
Phone
(770) 227-1264

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X DHR125R0002 GA Primary

Addresses

Primary practice location

240 Odell Rd
Griffin, GA 30224-4787

Mailing address

PO Box 278
Griffin, GA 30224-0007
Phone (770) 227-1264

Other identifiers 1

IdentifierTypeStateIssuer
000536962FMedicaidGA

Other names 1

  • CareMaster Medical Service Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Caremaster Medical Service6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209600000000",
    "number": "1063563112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 278",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302240007",
            "telephone_number": "770-227-1264",
            "fax_number": "770-228-9986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 ODELL RD",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302244787",
            "telephone_number": "770-227-1264",
            "fax_number": "770-228-9986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRN POOL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2008-05-01",
        "status": "A",
        "authorized_official_last_name": "GROGAN",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "770-227-1264",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "GA",
            "license": "DHR125R0002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000536962F",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CareMaster Medical Service",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Griffin, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.