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NPI Code Detail

MEDICARE: PRN POOL INC

MEDICARE: PRN POOL 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
1251E00000XHome Health AgencyDHR126R0002GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1447320007
Entity Type Code : Organization
Provider Name (Legal Business Name) : PRN POOL INC
Provider Business Mailing Address
First Line : PO BOX 278
Second Line :
City : GRIFFIN
State : GA
Zip : 30224-0007
Country : US
Telephone Number : 770-227-1264
Fax Number : 770-228-9986
Provider Business Practice Location Address
First Line : 240 ODELL RD
Second Line :
City : GRIFFIN
State : GA
Zip : 30224-4787
Country : US
Telephone Number : 770-227-1264
Fax Number : 770-228-9986
Authorized Official
Title or Position : CEO
Name : MR. CHARLES E GROGAN
Credential :
Telephone Number : 770-227-1264
Provider Enumeration Date : 11/09/2006
Last Update Date : 05/01/2008

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Directions to “PRN POOL INC ” Practice Location

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