Pure Life Renal of Perimeter, LLC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

PURE LIFE RENAL OF PERIMETER, LLC

Practice address

6160 Peachtree Dunwoody Rd
Suite a-110
Atlanta, GA 30328-4578

Phone

(954) 962-5733

NPI assigned

Dec 7, 2016

Last updated

Aug 12, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Jeff Fernandez

Title

Cfo

Phone

(954) 962-5734

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1481068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660262400000",
    "number": "1073057295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 HOLLYWOOD BLVD",
            "address_2": "SUITE 300N",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330216751",
            "telephone_number": "954-962-5734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6160 PEACHTREE DUNWOODY RD",
            "address_2": "SUITE A-110",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303284578",
            "telephone_number": "954-962-5733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURE LIFE RENAL OF PERIMETER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-07",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "status": "A",
        "authorized_official_last_name": "FERNANDEZ",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "954-962-5734",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Atlanta, GA
• Providers in Atlanta, GA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.