Pristine Care Group, LLC

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

Legal business name

PRISTINE CARE GROUP, LLC

Practice address

1507 Grandview Drive
Fayetteville, NC 28314-1806

Phone

(910) 302-8455

NPI assigned

Oct 22, 2019

Last updated

Oct 22, 2019By 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

Mrs. Jovan Latoya Bowser

Title

Coo

Phone

(910) 302-8455

Specialties & licenses 5

Addresses

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

{
    "created_epoch": "1571702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571702400000",
    "number": "1427691500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 GRANDVIEW DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283141806",
            "telephone_number": "910-302-8455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1507 GRANDVIEW DRIVE",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283141806",
            "telephone_number": "910-302-8455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRISTINE CARE GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-22",
        "last_updated": "2019-10-22",
        "status": "A",
        "authorized_official_last_name": "BOWSER",
        "authorized_official_first_name": "JOVAN",
        "authorized_official_middle_name": "LATOYA",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "910-302-8455",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332U00000X",
            "taxonomy_group": "",
            "desc": "Home Delivered Meals",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Non-emergency Medical Transport (VAN) in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Non-emergency Medical Transport (VAN) in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2019; 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.