Healthcare Provider Details

I. General information

NPI: 1447303664
Provider Name (Legal Business Name): PRESCRIPTION IN HOME SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 05/31/2025
Certification Date: 05/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1227 LAURANT AVE
CARUTHERSVILLE MO
63830-2145
US

IV. Provider business mailing address

1227 LAURANT AVE
CARUTHERSVILLE MO
63830-2145
US

V. Phone/Fax

Practice location:
  • Phone: 573-333-0030
  • Fax: 573-333-0023
Mailing address:
  • Phone: 573-333-0030
  • Fax: 573-333-0023

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number0008002
License Number StateMO

VIII. Authorized Official

Name: EMILY DAVIS
Title or Position: DESIGNATED MANAGER
Credential:
Phone: 573-333-0030