Organization
P & R HOME IV SERVICE, INC.
Active
Other names
P & R MEDICAL CONNECTION
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ROBIN SUE FARRIS (SECRETARY/TREASURER)
(800) 587-7670
Entity
Organization
Contact information
Practice address
1100 MERCER AVE, SUITE A122, DECATUR, IN 46733-2303
(800) 587-7670
(260) 724-3022
Mailing address
16937 DEFIANCE TRL, VAN WERT, OH 45891-8619
(800) 587-7670
(419) 587-2030
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
69000726A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201007250A
—
IN
Enumeration date
07/02/2014
Last updated
07/02/2014
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