Provider Demographics
NPI:1376238949
Name:BLOOMBUD LLC
Entity Type:Organization
Organization Name:BLOOMBUD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O
Authorized Official - Prefix:
Authorized Official - First Name:ISAAC
Authorized Official - Middle Name:
Authorized Official - Last Name:OLALEYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-398-9142
Mailing Address - Street 1:5523 WILKERSON PASS DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80917-2304
Mailing Address - Country:US
Mailing Address - Phone:719-398-9142
Mailing Address - Fax:
Practice Address - Street 1:5523 WILKERSON PASS DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80917-2304
Practice Address - Country:US
Practice Address - Phone:719-398-9142
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-10
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)