Provider Demographics
NPI:1780837294
Name:PRN MEDSTAFF HOMECARE INC
Entity Type:Organization
Organization Name:PRN MEDSTAFF HOMECARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:CERVANTESBROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-248-9545
Mailing Address - Street 1:10922 AXIS XING
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78245-3454
Mailing Address - Country:US
Mailing Address - Phone:210-833-6320
Mailing Address - Fax:866-929-6084
Practice Address - Street 1:10922 AXIS XING
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78245-3454
Practice Address - Country:US
Practice Address - Phone:210-833-6320
Practice Address - Fax:866-929-6084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-28
Last Update Date:2009-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health