Provider Demographics
NPI:1912207556
Name:PRO MEDICAL SERVICES, INC.
Entity Type:Organization
Organization Name:PRO MEDICAL SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED AGENT / OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:ADANENE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-390-2590
Mailing Address - Street 1:14697 80TH PL N STE #ML
Mailing Address - Street 2:P O BOX 1681
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55311-6681
Mailing Address - Country:US
Mailing Address - Phone:763-390-2561
Mailing Address - Fax:
Practice Address - Street 1:14697 80TH PL N STE ML
Practice Address - Street 2:
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55311-2154
Practice Address - Country:US
Practice Address - Phone:763-390-2561
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-29
Last Update Date:2024-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care