Organization
P & R HOME IV SERVICE INC
Active
Other names
P&R MEDICAL CONNECTION, P&R Home IV Service, Inc
Organization subpart
No
Provider details
NPI number
Authorized official
PHILLIP FARRIS BS (PRES)
(800) 587-7670
Entity
Organization
Contact information
Practice address
16937 DEFIANCE TRL, VAN WERT, OH 45891-8619
(419) 587-3349
(419) 587-3229
Mailing address
16937 DEFIANCE TRL, VAN WERT, OH 45891-8619
(419) 587-3349
(419) 587-3229
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
Primary
020434900
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0631301
—
OH
01
—
2072767
PK
—
Enumeration date
08/16/2006
Last updated
09/07/2017
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