Provider Demographics
NPI:1477218378
Name:PURE SCREENING SOLUTIONS LLC,
Entity Type:Organization
Organization Name:PURE SCREENING SOLUTIONS LLC,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:S
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-681-8437
Mailing Address - Street 1:4509 NW 23RD AVE STE 18
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-6570
Mailing Address - Country:US
Mailing Address - Phone:352-681-8437
Mailing Address - Fax:352-451-4492
Practice Address - Street 1:4509 NW 23RD AVE STE 18
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-6570
Practice Address - Country:US
Practice Address - Phone:352-681-8437
Practice Address - Fax:352-451-4492
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-04
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory