Provider Demographics
NPI:1649061243
Name:BLOOMBERG, ASHLEY MAY
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:MAY
Last Name:BLOOMBERG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:491 SANDY SPRINGS LN
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29073-9277
Mailing Address - Country:US
Mailing Address - Phone:803-521-1645
Mailing Address - Fax:
Practice Address - Street 1:491 SANDY SPRINGS LN
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29073-9277
Practice Address - Country:US
Practice Address - Phone:803-521-1645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-14
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health