Provider Demographics
NPI:1619210077
Name:PRESCRIPTION HOME CARE LLC
Entity Type:Organization
Organization Name:PRESCRIPTION HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANA
Authorized Official - Middle Name:ILIANA
Authorized Official - Last Name:KNIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:218-371-7838
Mailing Address - Street 1:36144 RUSH LAKE LOOP
Mailing Address - Street 2:
Mailing Address - City:OTTERTAIL
Mailing Address - State:MN
Mailing Address - Zip Code:56571-9430
Mailing Address - Country:US
Mailing Address - Phone:218-371-7838
Mailing Address - Fax:
Practice Address - Street 1:36144 RUSH LAKE LOOP
Practice Address - Street 2:
Practice Address - City:OTTERTAIL
Practice Address - State:MN
Practice Address - Zip Code:56571-9430
Practice Address - Country:US
Practice Address - Phone:218-371-7838
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-03
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN29284251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health