P & R Home IV Service, Inc.

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

License

69000726A Issued in IN

Legal business name

P & R HOME IV SERVICE, INC.

Doing business as

P & R MEDICAL CONNECTION

Practice address

1100 Mercer Ave
Suite A122
Decatur, IN 46733-2303

Phone

(800) 587-7670

Fax

(260) 724-3022

NPI assigned

Jul 2, 2014

Organization subpart

No

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

Authorized official

Name

Mrs. Robin Sue Farris

Title

Secretary/Treasurer

Phone

(800) 587-7670

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• P & R MEDICAL CONNECTION Doing business as

Tax ID family

P R Home IV Service Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

• P & R Home IV Service Inc

  • Community/Retail Pharmacy
  • Van Wert, OH
  • NPI 1578700399
  NPD tax ID
• P & R Home IV Service, Inc.

  • Oxygen Equipment & Supplies (DME)
  • Defiance, OH
  • NPI 1265857924
  NPD tax ID
• P & R Home IV Service, Inc.

  • Oxygen Equipment & Supplies (DME)
  • Bryan, OH
  • NPI 1730564840
  NPD tax ID
• P & R Home IV Service, Inc.

  • Oxygen Equipment & Supplies (DME)
  • Van Wert, OH
  • NPI 1962817874
  NPD tax ID

Locations

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

{
    "created_epoch": "1404259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404259200000",
    "number": "1467868174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16937 DEFIANCE TRL",
            "city": "VAN WERT",
            "state": "OH",
            "postal_code": "458918619",
            "telephone_number": "800-587-7670",
            "fax_number": "419-587-2030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 MERCER AVE",
            "address_2": "SUITE A122",
            "city": "DECATUR",
            "state": "IN",
            "postal_code": "467332303",
            "telephone_number": "800-587-7670",
            "fax_number": "260-724-3022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "P & R HOME IV SERVICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-02",
        "last_updated": "2014-07-02",
        "status": "A",
        "authorized_official_last_name": "FARRIS",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "SECRETARY/TREASURER",
        "authorized_official_telephone_number": "800-587-7670",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "IN",
            "license": "69000726A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201007250A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "P & R MEDICAL CONNECTION",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Oxygen Equipment & Supplies (DME) in Decatur, IN
• Providers in Decatur, IN by specialty
• Oxygen Equipment & Supplies (DME) in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2014; 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.