PURE LIFE CLINIC LLC – NPI #1932677291
Clinic/Center

PURE LIFE CLINIC LLC is an AHC clinic located in INDIANAPOLIS, IN. NPPES has assigned the NPI number 1932677291 to PURE LIFE CLINIC LLC on November 05, 2018. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QM1300X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Multi-Specialty

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for PURE LIFE CLINIC LLC below.

NPI Profile for
PURE LIFE CLINIC LLC

NPI Number
1932677291
Enumeration Date

(more than 7 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
PURE LIFE CLINIC LLC
Primary location
4725 STATESMEN DR STE B
INDIANAPOLIS, IN 46250-5645
Phone: (480) 566-9755 Fax:
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
SHAWN VIGNEAU
SOLE MBR
Phone: (480) 290-9899
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QM1300X
- Clinic/Center / Multi-Specialty (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.