Organization
PROFESSIONALS PRN LLC
Active
Other names
NORTHSIDE HOME INFUSION
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD JAY STOEPFEL (DIRECTOR)
(740) 454-5666
Entity
Organization
Contact information
Practice address
21 N MAYSVILLE AVE, ZANESVILLE, OH 43701-6110
(740) 452-2447
(740) 452-1399
Mailing address
21 N MAYSVILLE AVE, ZANESVILLE, OH 43701-6110
(740) 452-2447
(740) 452-1399
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
Primary
021068550
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2056902
—
OH
01
—
2077516
PK
—
Enumeration date
06/14/2006
Last updated
04/25/2021
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