Provider Demographics
NPI:1457162844
Name:DODI PURE CARE LLC
Entity type:Organization
Organization Name:DODI PURE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLENE
Authorized Official - Middle Name:ELVIRA
Authorized Official - Last Name:MUGISHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-685-5650
Mailing Address - Street 1:2925 IOWA LN APT 101
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58503-5384
Mailing Address - Country:US
Mailing Address - Phone:469-685-5650
Mailing Address - Fax:
Practice Address - Street 1:2925 IOWA LN APT 101
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58503-5384
Practice Address - Country:US
Practice Address - Phone:469-685-5650
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-15
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care