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
1113 S. SHANNON STREET, VAN WERT, OH 45891-8619
(419) 238-9828
(419) 238-6289
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
HMER.22207
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0631301
—
OH
01
—
1124131925
MEDICARE NPI
OH
05
—
201007250A
—
IN
Enumeration date
06/30/2014
Last updated
06/30/2014
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