Provider Demographics
NPI:1902844996
Name:PROFESSIONALS PRN LLC
Entity Type:Organization
Organization Name:PROFESSIONALS PRN LLC
Other - Org Name:GENESIS OXYGEN AND SLEEP THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:NORMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-454-4773
Mailing Address - Street 1:133 N MAYSVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-6112
Mailing Address - Country:US
Mailing Address - Phone:740-454-5666
Mailing Address - Fax:740-452-7563
Practice Address - Street 1:23 N MAYSVILLE AVE
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-6110
Practice Address - Country:US
Practice Address - Phone:740-453-0693
Practice Address - Fax:740-453-0748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH020982300332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2000088Medicaid
OH2000088Medicaid