Provider Demographics
NPI:1326496787
Name:PURE HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:PURE HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MISTY
Authorized Official - Middle Name:A
Authorized Official - Last Name:HAFFNER SZYNSKIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-542-0123
Mailing Address - Street 1:201 N 7TH ST
Mailing Address - Street 2:
Mailing Address - City:CLARINDA
Mailing Address - State:IA
Mailing Address - Zip Code:51632
Mailing Address - Country:US
Mailing Address - Phone:712-542-0123
Mailing Address - Fax:712-246-2594
Practice Address - Street 1:201 N 7TH ST
Practice Address - Street 2:
Practice Address - City:CLARINDA
Practice Address - State:IA
Practice Address - Zip Code:51632
Practice Address - Country:US
Practice Address - Phone:712-542-0123
Practice Address - Fax:712-246-2594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-26
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health