Provider Demographics
NPI:1336582311
Name:PURE HOME HEALTH CARE
Entity Type:Organization
Organization Name:PURE HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VICKI
Authorized Official - Middle Name:
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:419-376-4350
Mailing Address - Street 1:4145 LEVIS COMMONS BLVD
Mailing Address - Street 2:
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551-7135
Mailing Address - Country:US
Mailing Address - Phone:419-872-6666
Mailing Address - Fax:419-872-6667
Practice Address - Street 1:4145 LEVIS COMMONS BLVD
Practice Address - Street 2:
Practice Address - City:PERRYSBURG
Practice Address - State:OH
Practice Address - Zip Code:43551-7135
Practice Address - Country:US
Practice Address - Phone:419-872-6666
Practice Address - Fax:419-872-6667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-09
Last Update Date:2013-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2180033251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health