Healthcare Provider Details

I. General information

NPI: 1619115045
Provider Name (Legal Business Name): PURE HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2009
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7575 PARAGON RD
DAYTON OH
45459-5316
US

IV. Provider business mailing address

7575 PARAGON RD
DAYTON OH
45459-5316
US

V. Phone/Fax

Practice location:
  • Phone: 937-668-7873
  • Fax: 888-965-4549
Mailing address:
  • Phone: 937-668-7873
  • Fax: 888-965-4549

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number
License Number State

VIII. Authorized Official

Name: ANTHONY EVANS
Title or Position: PRESIDENT
Credential:
Phone: 937-269-3983