Provider Demographics
NPI:1942538590
Name:PURE HEALTH SERVICES INC
Entity Type:Organization
Organization Name:PURE HEALTH SERVICES INC
Other - Org Name:PURE HEALTH SERVICE INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ARA
Authorized Official - Middle Name:
Authorized Official - Last Name:BADALYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-990-5555
Mailing Address - Street 1:5255 ZELZAH AVE APT 108
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-2150
Mailing Address - Country:US
Mailing Address - Phone:818-990-5555
Mailing Address - Fax:818-990-5577
Practice Address - Street 1:5255 ZELZAH AVE APT 108
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-2150
Practice Address - Country:US
Practice Address - Phone:818-990-5555
Practice Address - Fax:818-990-5577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-19
Last Update Date:2009-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare