Healthcare Provider Details

I. General information

NPI: 1699683540
Provider Name (Legal Business Name): BLUEFIRE MED LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 WESTPORT PL
MANHATTAN KS
66502-2913
US

IV. Provider business mailing address

915 WESTPORT PL
MANHATTAN KS
66502-2913
US

V. Phone/Fax

Practice location:
  • Phone: 785-539-9218
  • Fax: 785-542-6149
Mailing address:
  • Phone: 785-539-9218
  • Fax: 785-542-6149

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ANDREW POPE
Title or Position: OWNER/PHYSICIAN
Credential: MD
Phone: 785-539-9218