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NPI Code Detail

MEDICARE: RAYMOND VINCENT BLOOM PHARM.D.

MEDICARE: RAYMOND VINCENT BLOOM PHARM.D.
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
1183500000XPharmacistPR27843ME

General Provider Information

NPI Number : 1467860056
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAYMOND VINCENT BLOOM PHARM.D.
Provider Business Mailing Address
First Line : 674 RIVER RD
Second Line :
City : NORRIDGEWOCK
State : ME
Zip : 04957-3423
Country : US
Telephone Number : 207-474-8928
Fax Number :
Provider Business Practice Location Address
First Line : 225 MADISON AVE
Second Line :
City : SKOWHEGAN
State : ME
Zip : 04976-2054
Country : US
Telephone Number : 207-474-2525
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2014
Last Update Date : 07/26/2014

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