| Pure Healthcare Of Nevada Llc | |
|
1865 Plumas St Ste 4 Reno NV 89509-3386 | |
| (775) 218-9020 | |
| Not Available |
| Full Name | Pure Healthcare Of Nevada Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1865 Plumas St Ste 4, Reno, Nevada |
| Authorized Official Name and Position | Joshua Tandy (DIRECTOR) |
| Authorized Official Contact | 8017870731 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pure Healthcare Of Nevada Llc 4179 S Riverboat Rd Ste 220 Taylorsville UT 84123-2986 Ph: (855) 550-3358 | Pure Healthcare Of Nevada Llc 1865 Plumas St Ste 4 Reno NV 89509-3386 Ph: (775) 218-9020 |
| NPI Number | 1932871308 |
|---|---|
| Provider Enumeration Date | 10/04/2021 |
| Last Update Date | 06/15/2023 |
| Medicare PECOS PAC ID | 2264826544 |
|---|---|
| Medicare Enrollment ID | O20220302002238 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932871308 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Abigail Christine Souza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003499013 PECOS PAC ID: 1355744541 Enrollment ID: I20210726002578 |
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