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Contact Information

PRC ENTERPRISES
650 VINE ST
POPLAR BLUFF, MO63901-5039
 Phone: 573-778-1126
 Fax: 573-785-4887
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Intellectual & Developmental Disabilities

103TM1800X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for PRC ENTERPRISES

NPI # 1508925025
LBN Legal business name PRC ENTERPRISES
Authorized official PATRICIA CAMPBELL - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 12/08/2006
Last updated 06/12/2008 - About 18 years ago
Identifiers
MO License # 14078480
MO Medicaid 193400000X
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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