Provider Demographics
NPI:1366420515
Name:PRN HOME CARE, INC.
Entity type:Organization
Organization Name:PRN HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:O'REILLY
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:321-960-0195
Mailing Address - Street 1:7155 MURRELL RD STE 101
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-8258
Mailing Address - Country:US
Mailing Address - Phone:321-751-6390
Mailing Address - Fax:321-751-6389
Practice Address - Street 1:7155 MURRELL RD STE 101
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-8258
Practice Address - Country:US
Practice Address - Phone:321-751-6390
Practice Address - Fax:321-751-6389
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-06
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHHA299991877251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL108053Medicare ID - Type UnspecifiedHOME HEALTH AGENCY