Provider Demographics
NPI:1861638736
Name:PURE CARE HOME HEALTH SERVICE, INC
Entity Type:Organization
Organization Name:PURE CARE HOME HEALTH SERVICE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:EDU
Authorized Official - Middle Name:ALFRED
Authorized Official - Last Name:UDENZE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-285-2341
Mailing Address - Street 1:429 HUNTERS CREEK DR
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:TX
Mailing Address - Zip Code:75182-4607
Mailing Address - Country:US
Mailing Address - Phone:972-285-2341
Mailing Address - Fax:972-285-2366
Practice Address - Street 1:429 HUNTERS CREEK DR
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:TX
Practice Address - Zip Code:75182-4607
Practice Address - Country:US
Practice Address - Phone:972-285-2341
Practice Address - Fax:972-285-2366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-26
Last Update Date:2010-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health