Healthcare Provider Details

I. General information

NPI: 1003462581
Provider Name (Legal Business Name): BUMP HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2019
Last Update Date: 11/19/2024
Certification Date: 11/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7719 N PIONEER LN
PEORIA IL
61615-1910
US

IV. Provider business mailing address

7719 N PIONEER LN
PEORIA IL
61615-1910
US

V. Phone/Fax

Practice location:
  • Phone: 888-913-7879
  • Fax: 309-405-0268
Mailing address:
  • Phone: 888-913-7879
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. LELAND DANIEL DEEHRING
Title or Position: PRESIDENT
Credential:
Phone: 888-913-7879