Provider Demographics
NPI:1700845708
Name:PRANGE ENTERPRISES INC
Entity Type:Organization
Organization Name:PRANGE ENTERPRISES INC
Other - Org Name:PRANGE INTIMATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP
Authorized Official - Prefix:MRS
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:PRANGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-445-2747
Mailing Address - Street 1:2503 BERNADETTE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-4674
Mailing Address - Country:US
Mailing Address - Phone:573-445-2747
Mailing Address - Fax:573-445-2747
Practice Address - Street 1:2503 BERNADETTE DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-4674
Practice Address - Country:US
Practice Address - Phone:573-445-2747
Practice Address - Fax:573-445-2747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-20
Last Update Date:2009-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO0598750002Medicare ID - Type Unspecified