Healthcare Provider Details

I. General information

NPI: 1437029345
Provider Name (Legal Business Name): PRN PHARMACIES LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2025
Last Update Date: 12/22/2025
Certification Date: 12/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

517 E VIENNA ST STE D
ANNA IL
62906-2047
US

IV. Provider business mailing address

304 S COMMERCIAL ST
HARRISBURG IL
62946-2108
US

V. Phone/Fax

Practice location:
  • Phone: 618-833-4444
  • Fax: 618-833-4445
Mailing address:
  • Phone: 618-252-5349
  • Fax: 618-252-1395

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: BRAD LEDBETTER
Title or Position: VICE PRESIDENT
Credential:
Phone: 618-252-5349