Provider Demographics
NPI:1386818789
Name:PRN MEDICAL SERVICES, LLC
Entity Type:Organization
Organization Name:PRN MEDICAL SERVICES, LLC
Other - Org Name:SYMBIUS MEDICAL, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JEFFERY
Authorized Official - Middle Name:B
Authorized Official - Last Name:HENDRIX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-443-2996
Mailing Address - Street 1:8516 NW EXPRESSWAY
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73162-6010
Mailing Address - Country:US
Mailing Address - Phone:877-688-2729
Mailing Address - Fax:888-718-0633
Practice Address - Street 1:20333 N 19TH AVE STE 101
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-3602
Practice Address - Country:US
Practice Address - Phone:623-780-8686
Practice Address - Fax:623-780-1887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-16
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZC000945332B00000X, 332B00000X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ360688Medicaid
AZ6132530001Medicare NSC