Pure Life Clinic Llc in Indianapolis, IN

Pure Life Clinic Llc is a medicare enrolled primary clinic (Clinic/center - Multi-specialty) in Indianapolis, Indiana. The current practice location for Pure Life Clinic Llc is 4725 Statesmen Dr Ste B, Indianapolis, Indiana. For appointments, you can reach them via phone at (480) 566-9755. The mailing address for Pure Life Clinic Llc is 4725 Statesmen Dr Ste B, Indianapolis, Indiana and phone number is (480) 566-9755.

Pure Life Clinic Llc is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1932677291. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (480) 566-9755.

Contact Information

	Pure Life Clinic Llc
	4725 Statesmen Dr Ste B Indianapolis IN 46250-5645
	(480) 566-9755
	Not Available

Map and Direction

Primary Care Clinic Profile

Full Name	Pure Life Clinic Llc
Speciality	Clinic/Center
Location	4725 Statesmen Dr Ste B, Indianapolis, Indiana
Authorized Official Name and Position	Shawn Vigneau (SOLE MBR)
Authorized Official Contact	4802909899
Accepts Medicare Insurance	Yes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Pure Life Clinic Llc 4725 Statesmen Dr Ste B Indianapolis IN 46250-5645 Ph: (480) 566-9755	Pure Life Clinic Llc 4725 Statesmen Dr Ste B Indianapolis IN 46250-5645 Ph: (480) 566-9755

NPI Details:

NPI Number	1932677291
Provider Enumeration Date	11/05/2018
Last Update Date	11/05/2018

Medicare PECOS Information:

Medicare PECOS PAC ID	8921403049
Medicare Enrollment ID	O20210826002895

Medical Identifiers

Medical identifiers for Pure Life Clinic Llc such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1932677291	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
261QM1300X	Clinic/center - Multi-specialty	(* (Not Available))	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Pure Life Clinic Llc acts as a billing entity for following providers:

Provider Name	Rachel Lynn Boggus
Provider Type	Practitioner - Anesthesiology
Provider Identifiers	NPI Number: 1427215987 PECOS PAC ID: 3375707847 Enrollment ID: I20120613000192

Provider Name	Shawn Vigneau
Provider Type	Practitioner - Chiropractic
Provider Identifiers	NPI Number: 1912165275 PECOS PAC ID: 3072768241 Enrollment ID: I20210826002986

Reviews and Comments

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Pure Life Clinic Llc - Medicare Primary Care in Indianapolis, IN