Healthcare Provider Details

I. General information

NPI: 1265241962
Provider Name (Legal Business Name): PURE HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2025
Last Update Date: 06/04/2025
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 POPLAR HILL RD STE D
CHESAPEAKE VA
23321-5522
US

IV. Provider business mailing address

3800 POPLAR HILL RD STE D
CHESAPEAKE VA
23321-5522
US

V. Phone/Fax

Practice location:
  • Phone: 757-910-0777
  • Fax: 800-663-6808
Mailing address:
  • Phone: 757-910-0777
  • Fax: 800-663-6808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: ERICA MELITTA THOMPSON
Title or Position: ADMINISTRATOR
Credential:
Phone: 757-777-4761