Provider Demographics
NPI:1063125573
Name:PRN MEDICAL SUPPLY INC
Entity type:Organization
Organization Name:PRN MEDICAL SUPPLY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:IMAOBONG
Authorized Official - Middle Name:
Authorized Official - Last Name:EGES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-715-8391
Mailing Address - Street 1:9898 BISSONNET ST STE 277
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-8025
Mailing Address - Country:US
Mailing Address - Phone:281-846-6415
Mailing Address - Fax:281-846-6415
Practice Address - Street 1:9898 BISSONNET ST STE 277
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-8025
Practice Address - Country:US
Practice Address - Phone:281-846-6415
Practice Address - Fax:281-846-6415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-29
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies