Provider Demographics
NPI:1114956331
Name:PRN MEDICAL STAFFING, INC.
Entity Type:Organization
Organization Name:PRN MEDICAL STAFFING, INC.
Other - Org Name:PRN HOME HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMININSTRATOR,DON
Authorized Official - Prefix:MRS
Authorized Official - First Name:SULYNN
Authorized Official - Middle Name:HELEN
Authorized Official - Last Name:LIBERTI
Authorized Official - Suffix:
Authorized Official - Credentials:RN,DON
Authorized Official - Phone:570-398-1330
Mailing Address - Street 1:318 YOUNGS RD
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:PA
Mailing Address - Zip Code:17744-9038
Mailing Address - Country:US
Mailing Address - Phone:570-398-1330
Mailing Address - Fax:570-398-1705
Practice Address - Street 1:318 YOUNGS RD
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:PA
Practice Address - Zip Code:17744-9038
Practice Address - Country:US
Practice Address - Phone:570-398-1330
Practice Address - Fax:570-398-1705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-01
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA02750501251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA398057Medicare ID - Type Unspecified