PURE LIFE CLINIC LLC (NPI# 1932677291) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932677291 |
| Entity Type | Organization |
| Organization Name | PURE LIFE CLINIC LLC |
| Practice Address |
4725 Statesmen Dr Ste B Indianapolis IN 46250-5645 |
| Practice Telephone | 4805669755 |
| Mailing Telephone | 4805669755 |
| Enumeration Date | 2018-11-05 |
| Last Update Date | 2018-11-05 |
| Authorized Official Name | SHAWN VIGNEAU (SOLE MBR) |
| Authorized Official Telephone | 4802909899 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| Street Address |
4725 STATESMEN DR STE B |
| City | INDIANAPOLIS |
| State | IN |
| Zip Code | 46250-5645 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114482122 | Pro Surge Indy LLC | Clinic/Center | 4725 Statesmen Dr Ste B, Indianapolis, IN 46250-5645 | 2019-02-04 |
| 1609344969 | Pure Life Injury LLC | Clinic/Center | 4725 Statesmen Dr Ste B, Indianapolis, IN 46250-5645 | 2018-11-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861037004 | Angela L Davis | Pharmacist | 8520 Bash St, Indianapolis, IN 46250 | 2019-11-12 |
| 1710455738 | Physicians Wellness Associates LLC | Family Medicine | 4735 Statesmen Drive, Suite C, Indianapolis, IN 46250 | 2018-11-07 |
| 1891222584 | Confidential Drug LLC | Pharmacy | 8520 Bash St Ste D, Indianapolis, IN 46250 | 2017-05-12 |
| 1659813590 | Occupational Health Centers of The Southwest Pa | Clinic/Center | 8257 Center Run Rd, Indianapolis, IN 46250 | 2016-11-09 |
| 1194275669 | Lucina Treatment Center, LLC | Internal Medicine | 8140 Castleton Rd, Indianapolis, IN 46250 | 2016-10-09 |
| 1609126150 | Joseph Lee Deck | Physical Therapist | 7400 Jewel Lane, Indianapolis, IN 46250 | 2012-09-12 |
| 1447508254 | Choices Coordinated Care Solutions, Inc. | Clinic/Center | 7941 Castleway Drive, Indianapolis, IN 46250 | 2012-08-28 |
| 1568719854 | Lynda L. Blackwelder, LLC | Marriage & Family Therapist | 4735 Statesmen Dr., Suite A, Indianapolis, IN 46250 | 2012-08-06 |
| 1972859452 | Courtney B. Cortez | Nurse Practitioner | 12400 N Meridian Ste 100, Suite 500, Indianapolis, IN 46250 | 2012-08-02 |
| 1861761934 | Kb Medical, Inc. | Durable Medical Equipment & Medical Supplies | 8455, Castlewood Drive, Suite J, Idianapolis, IN 46250 | 2011-12-20 |
| Find all providers in zip 46250 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
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| 1518517523 | Jessica Goiffon PC | Clinic/Center | 123 Main St, Indianapolis, IN 68432 | 2019-09-12 |
| 1114323151 | Imsg Inc. | Clinic/Center | 3266 N Meridian St, Suite 708, Indianapolis, IN 46208-5846 | 2014-11-18 |
| 1063818771 | Healthworks Med Group of Indiana P C | Clinic/Center | 9115 Hague Rd, Indianapolis, IN 46256-1025 | 2014-11-06 |
| 1669770178 | Adult and Child Center | Clinic/Center | 8320 Madison Ave, Indianapolis, IN 46227-6066 | 2011-03-08 |
| 1912082314 | Leo Plouffe Jr. | Clinic/Center | Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN 46285-0001 | 2006-10-25 |
| 1831134576 | Integra Health Center, LLC | Clinic/Center | 8150 Oaklandon Rd, Suite 111, Indianapolis, IN 46236-9525 | 2006-06-17 |
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| 1184231037 | Crossover Health Medical Group | Clinic/Center | 434 Patrol Rd, Jeffersonville, IN 47130-7754 | 2020-09-24 |
| 1659984870 | Central Indiana Vascular Care, LLC. | Clinic/Center | 853 N Emerson Ave Ste F, Greenwood, IN 46143-5676 | 2020-08-27 |
| 1518528579 | Johnson Nichols Health Clinic, Inc. | Clinic/Center | 390 Erie Ave Ste A, Connersville, IN 47331-3177 | 2019-06-21 |
| 1417479247 | Crown Radiology Associates | Clinic/Center | 5363 Commerce Blvd Ste A, Crown Point, IN 46307-5325 | 2017-07-13 |
| 1477970440 | American Health Network of Indiana, LLC | Clinic/Center | 2625 N Morton St, Kyb Health and Wellness Clinic, Franklin, IN 46131-8820 | 2014-03-27 |
| 1952626715 | K & D Medical Services | Clinic/Center | 425 Joliet St Ste 125, Dyer, IN 46311-1775 | 2010-04-05 |
| 1407179559 | Forensic Nursing Specialties, Inc | Clinic/Center | 2270 Lake Ave, Suite 201, Fort Wayne, IN 46805-5359 | 2010-03-03 |
| 1235372277 | Lagrange Surgery Center, LLC | Clinic/Center | 2500 Ventura Way, Lagrange, IN 46761 | 2009-04-07 |
| 1093954950 | Community Health Partners of South Bend, Inc. | Clinic/Center | 1010 N Bendix Dr, South Bend, IN 46628-1925 | 2009-02-16 |
| 1235303165 | Elkhart Clinic, LLC | Clinic/Center | 410 Park Pl, Suite B, Mishawaka, IN 46545-3557 | 2008-04-22 |
| Find all providers with the same taxonomy | ||||
| City | INDIANAPOLIS |
| Zip Code | 46250 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.