Pristine Home Health Services LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

PRISTINE HOME HEALTH SERVICES LLC

Practice address

1137 Heatherstone Dr
Fredericksburg, VA 22407-4828

Phone

(540) 548-2958

Fax

(540) 548-2935

NPI assigned

Feb 4, 2021

Organization subpart

No

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

Authorized official

Name

Mona Bailey

Title

Owner

Phone

(302) 898-7767

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1612396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612396800000",
    "number": "1417549239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1137 HEATHERSTONE DR",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224074828",
            "telephone_number": "540-548-2958",
            "fax_number": "540-548-2935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1137 HEATHERSTONE DR",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224074828",
            "telephone_number": "540-548-2958",
            "fax_number": "540-548-2935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRISTINE HOME HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-04",
        "last_updated": "2021-02-04",
        "certification_date": "2021-02-04",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "MONA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "302-898-7767"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2021; 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.