Provider Demographics
NPI:1619115045
Name:PURE HEALTHCARE LLC
Entity Type:Organization
Organization Name:PURE HEALTHCARE LLC
Other - Org Name:INNOVATIVE CARE SOLUTIONS LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:VP OF FINANCE AND ANALYTICS
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:KEMPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-479-0377
Mailing Address - Street 1:2200 MIAMI VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45459-4783
Mailing Address - Country:US
Mailing Address - Phone:937-668-7873
Mailing Address - Fax:888-965-4549
Practice Address - Street 1:2200 MIAMI VALLEY DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45459-4783
Practice Address - Country:US
Practice Address - Phone:937-668-7873
Practice Address - Fax:888-965-4549
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE HOSPICE OF DAYTON, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-01-22
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Multi-Specialty
No207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative MedicineGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistGroup - Multi-Specialty