Provider Demographics
NPI:1922501691
Name:PURE HEALTH MANAGEMENT INC.
Entity Type:Organization
Organization Name:PURE HEALTH MANAGEMENT INC.
Other - Org Name:LIVE WELL CHIROPRACTIC AND MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:T
Authorized Official - Last Name:HANES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:740-773-9355
Mailing Address - Street 1:6 MEDICAL DRIVE
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-8603
Mailing Address - Country:US
Mailing Address - Phone:740-773-9355
Mailing Address - Fax:740-771-4285
Practice Address - Street 1:6 MEDICAL DRIVE
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-8603
Practice Address - Country:US
Practice Address - Phone:740-773-9355
Practice Address - Fax:740-771-4285
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-08
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0308985Medicaid