Healthcare Provider Details

I. General information

NPI: 1922501691
Provider Name (Legal Business Name): PURE HEALTH MANAGEMENT INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2018
Last Update Date: 06/10/2024
Certification Date: 06/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 MEDICAL DRIVE
CHILLICOTHEE OH
45601-8603
US

IV. Provider business mailing address

6 MEDICAL DRIVE
CHILLICOTHEE OH
45601-8603
US

V. Phone/Fax

Practice location:
  • Phone: 740-773-9355
  • Fax: 740-771-4285
Mailing address:
  • Phone: 740-773-9355
  • Fax: 740-771-4285

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JEFFREY T HANES
Title or Position: OWNER/PRESIDENT
Credential: DC
Phone: 740-773-9355