Provider Demographics
NPI:1386398352
Name:PURE WELLNESS OF CAMDEN, LLC
Entity type:Organization
Organization Name:PURE WELLNESS OF CAMDEN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:CORBETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-365-6520
Mailing Address - Street 1:550 STANTON CHRISTIANA RD STE 302
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2132
Mailing Address - Country:US
Mailing Address - Phone:302-365-6520
Mailing Address - Fax:302-384-7564
Practice Address - Street 1:4608 S DUPONT HWY STE 3
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19901-6408
Practice Address - Country:US
Practice Address - Phone:302-365-6520
Practice Address - Fax:302-384-7564
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-09
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty