Provider Demographics
NPI:1194237735
Name:PRN PHARMACIES LTD
Entity type:Organization
Organization Name:PRN PHARMACIES LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:
Authorized Official - Last Name:LEDBETTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-252-5349
Mailing Address - Street 1:304 S COMMERCIAL ST
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:IL
Mailing Address - Zip Code:62946-2108
Mailing Address - Country:US
Mailing Address - Phone:618-252-5349
Mailing Address - Fax:618-252-1395
Practice Address - Street 1:254 NORTH LINCOLN BLVD. EAST
Practice Address - Street 2:
Practice Address - City:SHAWNEETOWN
Practice Address - State:IL
Practice Address - Zip Code:62984
Practice Address - Country:US
Practice Address - Phone:618-269-6205
Practice Address - Fax:618-269-6208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-03
Last Update Date:2017-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy