MEDICARE: PRO RESOURCES INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency		IN

General Provider Information

NPI Number	:	1417961475
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRO RESOURCES INC.

Provider Business Mailing Address
First Line	:	1728 SPY RUN
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46805
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5933 E STATE BLVD
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46815
Country	:	US
Telephone Number	:	260-969-3488
Fax Number	:	260-424-2204

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	WILLIAM BECKER
Credential	:
Telephone Number	:	260-969-3488

Provider Enumeration Date	:	07/27/2006
Last Update Date	:	08/22/2020

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