MEDICARE: BLM CO. INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility	0549	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053318485
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLM CO. INC.

Provider Business Mailing Address
First Line	:	501 HUDSON ST
Second Line	:
City	:	EL DORADO
State	:	AR
Zip	:	71730-6573
Country	:	US
Telephone Number	:	870-862-5511
Fax Number	:	870-863-3240

Provider Business Practice Location Address
First Line	:	501 HUDSON ST
Second Line	:
City	:	EL DORADO
State	:	AR
Zip	:	71730-6573
Country	:	US
Telephone Number	:	870-862-5511
Fax Number	:	870-863-3240

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. DEBORAH MCKNIGHT
Credential	:
Telephone Number	:	870-862-5511

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	02/05/2010

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