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General NPI Number Information
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NPI Number | 1881771913
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Entity Type | Organization
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Legal Business Name | PRN HOME HEALTH AND HOSPICE, INC.
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 06/16/2011
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Provider Practice Location Address
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Address Line | 1010 LINCOLN ST
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City | WAMEGO
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State | KS
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Zip | 66547-1502
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Country | US
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Telephone | 785-456-7764
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Fax | 785-456-7194
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Provider Business Mailing Address
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Address Line | 1010 LINCOLN ST P.O.BOX 228
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City | WAMEGO
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State | KS
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Zip | 66547-1502
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Country | US
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Telephone | 785-456-7764
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Fax | 785-456-7194
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Authorized Official
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Title or Position | ASSISTANT ADMINISTRATOR
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Name | MRS. PAMELA J FULMER
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Credential |
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Telephone | 785-456-7764
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WH1000X
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Taxonomy Name | Hospice Registered Nurse
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License Number | A075003
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License Number State | KS
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