Healthcare Provider Details

I. General information

NPI: 1700845708
Provider Name (Legal Business Name): PRANGE ENTERPRISES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2006
Last Update Date: 02/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2503 BERNADETTE DR
COLUMBIA MO
65203-4674
US

IV. Provider business mailing address

2503 BERNADETTE DR
COLUMBIA MO
65203-4674
US

V. Phone/Fax

Practice location:
  • Phone: 573-445-2747
  • Fax: 573-445-2747
Mailing address:
  • Phone: 573-445-2747
  • Fax: 573-445-2747

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MRS. JEAN M PRANGE
Title or Position: VP
Credential:
Phone: 573-445-2747