Provider Demographics
NPI:1487748570
Name:P.R.N. HOME HEALTH AGENCY LP
Entity type:Organization
Organization Name:P.R.N. HOME HEALTH AGENCY LP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:M
Authorized Official - Last Name:LUFFY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-860-8222
Mailing Address - Street 1:573 BRADDOCK AVENUE
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:EAST PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15112
Mailing Address - Country:US
Mailing Address - Phone:800-860-8222
Mailing Address - Fax:412-824-6390
Practice Address - Street 1:573 BRADDOCK AVENUE
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:EAST PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15112
Practice Address - Country:US
Practice Address - Phone:800-211-6002
Practice Address - Fax:412-824-6390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA767405251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1018536040001Medicaid
PA767405Medicare ID - Type UnspecifiedDOH LICENSE NUMBER
PA1018536040001Medicaid