Provider Demographics
NPI:1386898948
Name:PUREHOMECARESERVICES
Entity type:Organization
Organization Name:PUREHOMECARESERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:ELTRINGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:CSA
Authorized Official - Phone:586-293-2457
Mailing Address - Street 1:31275 FRASER DR
Mailing Address - Street 2:
Mailing Address - City:FRASER
Mailing Address - State:MI
Mailing Address - Zip Code:48026-2572
Mailing Address - Country:US
Mailing Address - Phone:586-293-2457
Mailing Address - Fax:586-294-7407
Practice Address - Street 1:31275 FRASER DR
Practice Address - Street 2:
Practice Address - City:FRASER
Practice Address - State:MI
Practice Address - Zip Code:48026-2572
Practice Address - Country:US
Practice Address - Phone:586-293-2457
Practice Address - Fax:586-294-7407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-10
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization