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General NPI Number Information
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NPI Number | 1295573897
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Entity Type | Organization
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Legal Business Name | BLOOMING HEALTHCARE SERVICES LLC
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Dates
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Enumeration Date | 07/17/2024
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Last Update Date | 07/17/2024
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Provider Practice Location Address
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Address Line | 11746 JEFF HEARN RD SUITE 102
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City | COLLINSVILLE
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State | MS
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Zip | 39325
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Country | US
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Telephone | 601-342-0474
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 525
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City | SHUBUTA
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State | MS
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Zip | 39360-0525
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Country | US
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Telephone | 601-966-4661
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | CASSIE CARTER
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Credential | MHA, BS
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Telephone | 601-966-4661
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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