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General NPI Number Information
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NPI Number | 1386404887
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Entity Type | Organization
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Legal Business Name | HEARTS PURE LLC
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Dates
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Enumeration Date | 03/21/2024
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Last Update Date | 03/21/2024
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Provider Practice Location Address
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Address Line | 16101 VENTURA BLVD STE 215
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City | ENCINO
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State | CA
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Zip | 91436-2512
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Country | US
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Telephone | 850-850-4247
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Fax |
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Provider Business Mailing Address
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Address Line | 23679 CALABASAS RD UNIT 503
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City | CALABASAS
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State | CA
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Zip | 91302-1502
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Country | US
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Telephone | 850-850-4247
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANGELA WHITE
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Credential |
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Telephone | 850-850-4247
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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