MEDICARE: PURE MEMPHIS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1942153226
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PURE MEMPHIS LLC

Provider Business Mailing Address
First Line	:	4886 JUDY LYNN AVE
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38118-2425
Country	:	US
Telephone Number	:	901-212-5328
Fax Number	:

Provider Business Practice Location Address
First Line	:	4886 JUDY LYNN AVE
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38118-2425
Country	:	US
Telephone Number	:	901-212-5328
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CRYSTAL COBLE
Credential	:
Telephone Number	:	901-212-5328

Provider Enumeration Date	:	02/17/2026
Last Update Date	:	02/17/2026

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Directions to “PURE MEMPHIS LLC ” Practice Location

Language	Start Address	Practice Location

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